【摘要】 目的探讨膀胱全切除术后原位M形回肠新膀胱的疗效。方法膀胱恶性肿瘤患者15例行膀胱全切除术,采用M形原位回肠新膀胱术进行尿流改道。结果围手术期无1例死亡,随访3-20个月(平均12.4个月)。膀胱容量(340±23.71)mL(210-430mL),膀胱充盈压为(20.12±0.64)cmH2O(13.50-33.91cmH2O),排尿膀胱压为(77.02±12.11)cmH2O(53.21-87.09cmH2O),残余尿(15.43±34.33)mL(3-88mL),最大尿流率(18.16±5.60)mL/s(11.38-19.17mL/s)。无明显输尿管梗阻及返流。未发现尿道残端复发肿瘤。无排尿困难者,白天均可控制排尿;术后大于6个月者无夜间遗尿,术后半年15例复查B超无肾积水表现,复查生化指标,肾功能电解质在正常范围内,1例术前肾积水及肾功能异常者术后为正常。结论原位回肠新膀胱术是较理想的膀胱全切术后的尿流改道方式。更多还原

【Abstract】 Objective To evaluate the outcomes of M-shaped orthotopic ileal neobladder. Methods A total of 15 patients （14 males and 1 female） with malignant bladder tumors underwent M-shaped orthotopic ileal neobladder after radical extraperitoneal cystoprostatectomy. Results The 15 patients were followed up for 3 to 20 months with a mean of 12.4 months. The volume of the bladder was （340±23.71）mL postoperatively. Urodynamic examination showed that the peak voiding pressure was （77.02±12.11）cm H₂O. The maximum flow rate （Qmax） was （18.16±5.60）mL/s. The residual urine was （15.43±34.33）mL. No remarkable ureter reflux and obstruction were found. No patient was detected to develop recurrent urethral carcinoma. Conclusion The neobladder is an ideal to treat invasive bladder tumor after total cystectomy.更多还原