【摘要】 目的 :观察 7年来行原位回肠代膀胱术的治疗效果。方法 :对 2 5例男性膀胱癌患者行膀胱全切回肠代膀胱术。结果 :2 5例患者中有 2 4例获得随访 ,随访时间 2～ 84个月 ,平均 2 4个月。手术时间平均 2 40 min,输血量平均 5 5 0 m l,手术并发症少 ,2 3例患者白天可控制排尿 ,其中 14例夜间自控排尿。 3例有肾脏或输尿管积水 ,2例肾功能异常。膀胱排尿造影均未发现输尿管反流。血生化检查除 2例发现低血钾外 ,其余血电解质均在正常范围。未发现肠膀胱或尿道肿瘤复发。结论 :原位回肠代膀胱术是值得选择的尿流改道方式。更多还原

【Abstract】 Purpose:To present a 7 year experience with ileal orthotopic neobladders.Methods:An neobledder was constructed using an ileal segment with a“W” type. 23 of 25 cases of ileal neobladders have been followed up for 2 to 84 months with a mean of 24 months.Results:Operating time ranged from 150 to 310 minutes with a mean of 240 minutes.1 died of cancer metastasis. All patients were satisfactory with the operation except 3 cases. 23 patients achieved excellent daytime continent, while only 14 had nighttime continent. The maximal effective capacity of the neobladder was 200 to 550 ml with a mean of 310 ml.11 patients have taken place inguinal hernia and 1 suffered from incision hernia.3 cases had mild renal dysfunction. 2 patients had hypokalcemia. On IVU examination, failure of imaging of unilateral kidney occurred in 2 patients. 3 cases of patients had unilateral ureter extension or hydronephrosis. 5 cases had their residual urine volume over 50 ml, and 1 case had neobladder stone discovered by BUS. Voiding cystography revealed no ureteral reflux. No patient suffered from neobladder or urethral recurrence.Conclusion:An ileal orthotopic neobladder offers an attractive alternative to a bladder substitute when cystectomy is required.更多还原