原位回肠新膀胱术不同输尿管肠管吻合术式并发症的比较分析  

COMPARATIVE STUDY OF THE DIFFERENT URETEROINTESTINAL ANASTOMOSIS IN ILEAL ORTHOTOPIC NEOBLADDER

作　　者：高双友[1] 曹凤宏 李双利[1] 宋蕊[1] 李连印[1] 温英武[1] 

机构地区：[1]华北理工大学附属开滦总医院泌尿外科,河北省唐山市063000 [2]华北理工大学附属医院泌尿外科

出　　处：《中国煤炭工业医学杂志》2016年第5期676-678,共3页Chinese Journal of Coal Industry Medicine

基　　金：唐山市科学技术研究与发展支撑计划项目(编号:10130229C)

摘　　要：目的对67例原位回肠新膀胱术采取2种不同输尿管肠管吻合术式的并发症进行比较,旨在为临床术式的选择提供指导。方法总结分析该院2004年2月—2015年11月期间行膀胱全切除-原位W形回肠新膀胱术67例,其中41例行输尿管肠管抗返流吻合术（抗返流吻合组）,26例行Nesbit法输尿管肠管直接吻合术（直接吻合组）,术后随访3~60个月,平均27个月,比较2种吻合术式术后吻合口狭窄、输尿管返流、肾功能损害及尿路感染的并发症的发生率。结果抗返流吻合组82条输尿管13条出现吻合口狭窄,而直接吻合组52条输尿管中3条出现吻合口狭窄,术后输尿管返流、肾功能损害及尿路感染的并发症的发生率差异无统计学意义（P〉0.05）。结论输尿管肠管直接吻合术式为有效防止狭窄的输尿管肠管吻合术式,是回肠原位新膀胱输尿管肠管吻的优选术式。Obiective To compare the two diffient of ureterointestinal anastomosis in ileal orthotopic neo-bladder and in order to provide guidance for clinical choice of operation. Methods The clinical data of 67 patients received toal cystectomy and W-shaped ileal orthotopic neobladde from Febryary 2004 to November 2015 in author＇s hospital were analyzed, 41 patients were treated by the antirefluxing technique and 26 patients were treated by the direct ureterointestinal anastomosis. They were assessed for 3 months to 60 months with a mean follow up of 27 months after operation. The follow up studies included following - up the information of ureteric stricture, ureteric reflux, renal function and acute urinary infection. Results Of 82 ureters reimplanted using antirefluxing technique, 13 of 82 ureters had anastomotic stricture; but in 52 ureters reimplanted using direct anastomoses, 3 of them ureters had anastomotic stricture, the significance difference between the direct and antirefluxing technique groups was obviously. Furthermore,there was no significant difference between the direct and antirefluxing technique groups in regard to ureteric reflux, renal function and acute urinary infection{P〉0.05）. Conclusion Nesbit anastomosis is the sufficient method to preivent anastomotic stricture, and the direct ureteroenteric anastomosis may be the suitable choice for the ureterointestinal anastomosis in ileal orthotopic neobladder.

关 键 词：回肠 新膀胱 输尿管 吻合术式 

分 类 号：R737.1[医药卫生—肿瘤]