腹腔镜下全膀胱切除并去带乙状结肠新膀胱术(附26例报告)  

Laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction: report of 26 cases

作　　者：郑少波[1] 刘春晓[1] 徐亚文[1] 

机构地区：[1]南方医科大学珠江医院泌尿外科,广东广州510282

出　　处：《第一军医大学学报》2005年第2期231-233,共3页Journal of First Military Medical University

基　　金：广东省医学科研基金(A2002412)~~

摘　　要：目的介绍腹腔镜下全膀胱切除、去带乙状结肠新膀胱术的经验.方法对2002年7月～2004年9月间26例膀胱癌患者的临床资料进行总结与分析.结果26例患者的手术时间为240～390min,其中腹腔镜下全膀胱切除术120～270min.腹腔镜手术中及术后未见明显出血,出血量＜200ml.开放性原位新膀胱术出血量400～800ml,输浓缩红细胞0～4个单位.术后4～8 d恢复饮食,3～8周拔除输尿管支架管,4周拔除尿管.术后3个月患者白天可完全控制排尿,8例夜间偶有尿失禁.结论腹腔镜下膀胱癌根治切除术创伤小、出血少、恢复快,是全膀胱切除手术中的一种很有前景的方法.全去带可控性乙状结肠新膀胱术具有手术操作简单、需用肠段短、贮尿囊在原位、尿液自尿道可控排出、术后并发症少等优点,具有较好的应用价值.Objective To review our experience with intracorporeal laparoscopic radical cystectomy and sigmoid colon orthotopic neobladder reconstruction. Methods The clinical data of 26 cases of bladder carcinoma treated with the indicated surgical procedures were reviewed. Results The surgeries were successful in all the cases with the operating time ranging from 240 to 390 min, blood loss of 400 to 800 ml and red-cell transfusion of 0-4 U. Oral food intake was allowed 4-8 days after the operation, ureteral stents were removed in weeks 3 to 8 and the pouch catheter was removed in week 4 postoperatively. Daytime urinary continence was excellent and urinary incontinence at night occurred in 8 patients 3 months after the operation. Conclusion Sigmoid colon orthotopic neobladder reconstruction can be effective for urinary diversion to ensure good quality of life of the patients.

关 键 词：外科手术 腹腔镜 膀胱切除术 膀胱肿瘤 乙状结肠/外科学 尿路分流术 

分 类 号：R737.14[医药卫生—肿瘤]