勃起神经保留性膀胱全切Roux-y乙状结肠新膀胱的临床结果  

Clinical Outcomes of Sexuality Preserving Cystectomy and Roux-y Sigmoid Neobladder

作　　者：夏维木[1] 刘定益 周文龙[3] 王名伟[3] 徐玉生[1] 王健 张立[1] 马春曦[1] 陈荣剑[1] 叶永峰[1] 

机构地区：[1]解放军第184医院泌尿外科,江西鹰潭335000 [2]上海浦南医院泌尿外科,上海200125 [3]上海交通大学医学院附属瑞金医院卢湾分院泌尿外科,上海200025

出　　处：《中华男科学杂志》2009年第9期806-808,共3页National Journal of Andrology

基　　金：中国人民解放军南京军区医学科学技术研究"十一五"计划资助项目(06MA80)~~

摘　　要：目的:观察勃起神经保留性膀胱全切和Roux-y乙状结肠新膀胱术后患者阴茎勃起功能、尿控、排尿和肿瘤复发情况。方法:共有18例患者进行了勃起神经保留性膀胱全切和Roux-y乙状结肠新膀胱术,评价肿瘤复发情况和功能性结果(尿控、排尿、勃起功能)。结果:平均随访41个月,2例分别于术后10个月和15个月死于癌症广泛性转移,这2例均为盆腔淋巴结阳性的患者。白天和夜间尿控率均为100%,11例患者有阴茎勃起功能,勃起率达61.1%,2例患者勃起功能受损,5例无勃起功能,手术前后ⅡEF-5评分为(13.72±6.39)、(10.83±8.25)分,差异有显著性(P<0.05)。结论:勃起神经保留性膀胱全切和Roux-y乙状结肠新膀胱术后患者阴茎勃起功能和尿控情况良好,肿瘤复发情况尚可接受,但仍需要长时间随访和大样本患者证实。Objective： To assess the penile erectile function, urinary continence and voiding, and cancer recurrence in 18 bladder cancer patients after sexuality preserving eystectomy and Roux-y sigmoid neobladder reconstruction. Methods ： Eighteen male patients with bladder cancer underwent sexuality preserving cysteetomy and Roux-y sigmoid neobladder reconstruction, and were followed up for cancer recurrence and such clinical outcomes as erectile function and urinary continence and voiding. Results ： The patients were fol- lowed up for an average of 41 months, of whom, all achieved day- and night-time urinary continence, but 2 with positive lymph nodes died of extensive metastasis at 10 and 15 months, respectively, after surgery. Among the total number, potency was maintained in 11 patients （61.1% ） , impaired in 2 and lost in 5, and the post-operative IIEF-5 score was （ 10.83± 8.25 ） as compared with （ 13.72± 6.39） before the operation, with a statistically significant difference （ P 〈 0.05 ）. Conclusion ： Erectile function and urinary continence are fairly good in bladder cancer patients after sexuality preserving cystectomy and Roux-y sigmoid neobladder reconstruc-tion, and the oncological results are fairly acceptable, but still need to be confirmed by longer follow-ups and larger trials.

关 键 词：膀胱肿瘤 膀胱切除 勃起功能 尿流改道 

分 类 号：R737.14[医药卫生—肿瘤]