去管化回肠S型缝合制作正位新膀胱三例报告  

Ileum to the S-type of suture produced orthotopic neobladder-with a three cases report

作　　者：郑奇传[1] 黄金国[1] 丁方成[1] 徐刚[1] 王刚[1] 

机构地区：[1]安徽省马鞍山市人民医院泌尿外科,243000

出　　处：《肿瘤研究与临床》2007年第12期829-830,共2页Cancer Research and Clinic

摘　　要：目的评价去管化回肠 S 型缝合制作正位新膀胱的临床应用价值。方法膀胱癌患者行膀胱全切后,采用带蒂末段回肠片经 S 形折叠后缝合形成的原位类球形新膀胱,输尿管以乳头法包埋术种植于新膀胱,新膀胱远端与尿道残端吻合。结果 3例患者平均手术时间为5h,术中平均出血量366 ml,术后随访1～18个月,3例白天均能控尿,夜尿1～3次,膀胱容量大,压力低,血电解质基本正常。超声检查无上尿路扩张积液,MRI 或膀胱镜检查无肿瘤复发,术后随访1～18个月,患者控尿、排尿满意,贮尿囊容量分别为250、320和450ml,平均340ml,剩余尿0～40ml。结论去管化回肠 S 型缝合制作正位新膀胱术操作简便,新膀胱容量大、术后并发症发生率低,是治疗浸润性、多发性膀胱癌的好方法。objective To evaluate the clinical application value of ileum to the S-type of suture pro- duced orthotopic neobladder.Methods Radical cystectomy and ileal neobladder with'S'shape were per- formed in 3patients with transitional cell carcinoma.Ureter implant into neobladder with embedding nipple techniques,bottom of neobladder coincide with urethra stump.Results The average operative time to form a neobladder was 5 hours,average bleeding volume was 366 ml during operation,3 cases can control urine dur- ing daytime,nycturia 1-3 times every night.Neobladder has a large capacity,low pressure,and electrolytes of blood was normal.Conclusion The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by S shape is easy and agreeable to perform.This mode of oper- ation has low complication rates,achieves adequate capacity at low pressure,and provides satisfactory conti- nence rates.It is a fine scheme to treat invasion and multiple carcinoma of bladder.

关 键 词：膀胱肿瘤 膀胱切除术 尿流改道术 

分 类 号：R737.14[医药卫生—肿瘤]