改良低压可控性回肠代膀胱术  

An appliance free continent ileal reservoir

作　　者：郭德荣[1] 许仲华[1] 胡贵祥 邓健 

机构地区：[1]广东省珠海市人民医院泌尿外科

出　　处：《中华泌尿外科杂志》1999年第1期23-24,共2页Chinese Journal of Urology

摘　　要：目的建立一种更接近生理的回肠代膀胱术。方法１９９１～１９９８年实施５例全膀胱切除，回肠膀胱与尿道吻合，由外括约肌控制，经尿道排尿的新手术方法。结果术后随访３～８４个月，平均２８．６个月。至随访日，５例无吻合口狭窄，排尿通畅。３个月后４例完全控制排尿，１例仍有不完全性尿失禁。结论该术式具有贮尿囊内压低（２０～３０ｃｍＨ２Ｏ），容量略小（２５０～３００ｍｌ），可控性和原位排尿的优点，且无电解质紊乱和肾功能损害。Objective To establish a better continent ileal urinary reservoir. Method Since march.1991,5 men 62 78 years old (mean age 68.4 years) underwent radical cystoprostatectomy for transitional cell carcinoma of the bladder and reconstruction and urine diversion were carried out by bilateral ureteroileal urethrostomy using an ileal reservoir. Results Neobladder compliance and emptying have been satisfactory in the 4 patients evaluated urodynamically.Good continence has been achieved during day and night in 80% of paitients at a median followup of 28.6 months (range 3 to 84).Early and late complication included 2 cases of minor urinary extravasation from the pouch through the drain sites,being ceased after 2 weeks of bladder drainage with on urethral catheter. Conlusions The benefits of the ileal reservoir so constructed are good continence,urination via the urethra as usual resonable capacity (250～300ml) with no electrolyte disorder or impairment of renal function.

关 键 词：膀胱肿瘤 全膀胱切除 回肠代膀胱术 可控性 

分 类 号：R737.140.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]