乙状结肠直肠膀胱术的随访观察（附34例报告）  

Following-up of patients with sigmoid rectal pouch for urinary division （report of 34 cases）

作　　者：邢继章[1] 洪泉[1] 孙斌[1] 周高标[1] 严景民[1] 姚志勇[1] 汪泽厚[1] 郭和清[1] 

机构地区：[1]空军总医院泌尿外科,北京100142

出　　处：《中国医师进修杂志》2016年第9期811-813,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的：积累乙状结肠直肠膀胱作为尿流改道术的临床经验。方法回顾性分析34例乙状结肠直肠膀胱术作为尿流改道方式患者的临床资料，总结并发症防治的临床经验。结果26例随访2个月至11年，失访10例。早期随访结果：术后高热伴一侧肾积水3例，术后近期耻骨后出血再次止血1例，切口裂开经再次减张缝合治愈3例，术后第10天发生乙状结肠直肠膀胱瘘1例。远期随访结果：尿道肿瘤复发1例，肿瘤远处转移5例，夜间溢尿5例，未见需临床处理的高氯性酸中毒、肾积水及逆行肾盂感染等严重并发症的病例。结论乙状结肠直肠膀胱术手术操作较简单，无严重并发症，患者易接受，是膀胱全切后一种较理想的可控性尿流改道方法。Objective To investigate the management and prevention of the complications of sigmoid rectal pouch for urinary division after radical cystectomy. Methods The clinical data of 34 patients who underwent a sigmoid rectal pouch procedure were analyzed retrospectively, and the clinical experience was summarized in the management and prevention of the complications of sigmoid rectal pouch for diversion. Results Twenty-six patients were followed up for 2 months to 11 years, and 10 patients lost in follow-up. The early follow-up results were as follows：3 patients had postoperative high fever with unilateral the kidney water, 1 patient had retropubic bleeding and need to stop bleeding, 3 patients suffered from wound split open and were performed relaxation suture, and 1 patient had sigmoid colon rectum bladder fistula 10d after operation. The late follow-up results were as follows：1 patient had urethral neoplasms recurrence, 5 patients developed distance metastases, and 5 patients developed nocturnal incontinence and worn safety pad. There were no hyperchloremic acidosis requiring clinical treatment, hydronephrosis as well as retrograde pelvis infection. Conclusions The operation of sigmoid＆nbsp;rectal pouch for urinary division is fairly simple, with no serious complication. It is a better alternative diversion procedure, and should be accepted gradually by patients and surgeons.

关 键 词：膀胱肿瘤 术后并发症 乙状结肠直肠膀胱术 

分 类 号：R737.14[医药卫生—肿瘤]