【摘要】 目的 观察直肠癌术后局部复发行全盆腔脏器切除术中将原乙状结肠造口改行结肠代膀胱的临床疗效。方法 回顾性分析自2009~2013年因腹会阴联合切除术后盆腔局部复发而行全盆腔脏器切除的12例的临床资料。该组患者均截取10~12 cm长的原有乙状结肠造口肠管改行结肠代膀胱,近端行横结肠襻式造口。术后1年为临床疗效观察终点。结果 该组行全盆腔脏器切除术平均手术时间为(348±47)min,术中平均失血量约为(630±110)ml。3例患者术后近期发生结肠代膀胱相关并发症,其中出血2例,黏膜部分坏死1例。患者术后1年生存率为66.7%(8/12)。术后1年内随访超声检查均未发现输尿管扩张、肾积水。结论 应用原有乙状结肠造口改行结肠代膀胱的方法 简单、手术时间短、泌尿造口相关并发症少,适应于选择性的直肠癌术后复发行全盆腔脏器切除的患者。更多还原

【Abstract】 Objective To explore the function and complications of modified sigmoid conduit in total pelvic exenteration(TPE) for rectal carcinoma patient with pelvic recurrences.Methods Retrospective analyses were conducted for 12 cases undergoing TPE for local recurrence after Miles operation from 2009 to 2013.The endpoint was set at 1 year after operatioa Results Among them,the mean operative duration was 308 47 min and estimated blood loss 430 110 ml.Short-term complications including sigmoid conduit bleeding(n = 2) and partial mucosa necrosis(n= 1).Post-operative 1-year survival rate was 66.7%(8/12).During 1-year follow-up,no ureteral hydronephrosis or dilation was found on ultrasonography.Conclusions Modified sigmoid conduit is simple and practicable for neobladder construction during TPE.更多还原