阑尾代后尿道及回盲、升结肠作储尿囊在正位膀胱重建术中应用  

Appendix as the outlet of ileocecum-colon continent reservoir with orthotopic bladder reconstruction

作　　者：王绍勇[1] 林海群[2] 周春文[1] 张建良[3] 

机构地区：[1]山东大学第二医院泌尿外科,山东济南250033 [2]山东省肿瘤医院放射肿瘤科,山东济南250017 [3]山东大学第二医院普通外科,山东济南250033

出　　处：《中国现代普通外科进展》2011年第4期296-298,共3页Chinese Journal of Current Advances in General Surgery

基　　金：山东省中青年科学家基金项目(2008BS03053)

摘　　要：目的：探讨阑尾代后尿道及回盲、升结肠作储尿囊在膀胱正位重建术中应用及其疗效。方法：2003年2月—2009年6月应用回盲肠及部分升结肠作储尿囊,以阑尾根部与后尿道吻合原位排尿的方法治疗膀胱肿瘤12例,应用尿动力学方法对其近期疗效进行随访。结果：7例完全控尿,2例有尿失禁,3例有夜间尿失禁。术后6个月排尿次数白天4~6次,夜间1~2次,每次量150~400 mL。尿动力学：平均尿流率10.5 mL/s,平均膀胱初始感觉压力27 cmH2O,最大充盈压35 cmH2O,相应储尿囊容量分别为152 mL和420 mL。后尿道闭合压力为52 cmH2O,残余尿量0~65 mL。结论：阑尾代后尿道和回盲、升结肠作储尿囊正位膀胱重建术,储尿囊内压低,容量大,有可控性和原位排尿的特点。Objective： To evaluate the effect of the urinary reservoir constructed with ileocecum-appendix.Methods： From 2003-2009,12 cases were treated using ileocecum-appendix as the reservoir after radical cystectomy.They all accepted the urodynamics examination.Results：7/12 patients are continence completely.2 cases are incontinence.Times of uresis,4~5 times/day,1~2 times/night.The capacity is 150~400 mL.The first pressure of the reservoir is 27cmH2O,the maxmam pressure is 35cmH2O.The average capacity is 265~450mL,respectively.The out let pressure of the appendix is 52cmH2O.The volume of residual urine is 0~65mL.No evindence of ureteral reflux occurred,no hyperchloremic has been observed.Conclosion： Orthotopic Bladder reconstruction was considered as an ideal form of urinary diversion characterized with low pressure,larger capacity and continence.

关 键 词：膀胱肿瘤 回肠 盲肠 阑尾 尿道 膀胱重建 尿动力学 

分 类 号：R737.14[医药卫生—肿瘤] R730.56[医药卫生—临床医学]