可控性尿流改道术中原位阑尾输出道的选择及应用  

The selection and application of appendix in situ in the continent urinary diversion

作　　者：肖克峰[1] 刘大乐[1] 章道恒[1] 陈彤[1] 吴志亮[1] 关志忱[1] 

机构地区：[1]暨南大学医学院附属深圳市人民医院泌尿外科,518020

出　　处：《中华外科杂志》2004年第10期577-579,共3页Chinese Journal of Surgery

摘　　要：目的　探讨在可控膀胱术中原位阑尾输出道的选择方法和临床应用经验。方法　自1990年以来共进行原位阑尾输出道的可控膀胱术 2 6例 ,其中阑尾套叠组 11例 ,阑尾埋藏组 15例。结果　全部患者白天尿流可控率为 10 0 % ;3例夜间间断尿失禁 ,均发生在阑尾套叠组 ;3例插管困难 ,1例阑尾穿孔 ,均发生在阑尾埋藏组 ;1例阑尾缩入腹腔 ,3例阑尾黏膜脱垂。结论　阑尾埋藏的方法较阑尾套叠的方法可控效果好 ,使用原位阑尾作输出道较其他方法有操作简单、省时、可控效果佳、并发症少等优点 ,我们认为原位阑尾输出道是尿流改道手术中一种理想的可供选择的方法。Objective To evaluate the selective method and the clinical experience of using appendix in situ in continent urinary diversion.Methods 26 continent urinary diversions have been performed since 1990. Among them, 11 cases underwent the intussuscepted technique and other 15 cases underwent embedded technique. Results The continent rate was 100% at the daytime among all the cases ,while intermittent incontinence occurred in 3 cases at night, which happened in the intussuscepted group. Other complications included catheterization difficulty in 3 cases, appendix perforation in 1 case,which happened in the embedded group, retraction of the appendix into abdominal cavity in 1 case, and prolapse of the intussuscepted appendix in 3 cases. Conclusions The embedded technique shows better results than the intussuscepted technique in term of continence. The embedded technique, using appendix in situ as an efferent loop, shows the advantages of easily performing, timesaving, better out come in continence and less complication. We believe the technique of appendix in situ as an efferent loop is an ideal modality in urinary diversion operation.

关 键 词：可控性尿流改道术 原位阑尾输出道 选择 应用 膀胱肿瘤 

分 类 号：R699.5[医药卫生—泌尿科学]