摘要
目的：探讨膀胱癌行全膀胱切除加Ｂｒｉｃｋｅｒ手术并发症的防治。方法：７６例多发性、复发或浸润性膀胱癌行全膀胱切除，用Ｂｒｉｃｋｅｒ术作尿流改道。术中用粘膜下隧道法作输尿管回肠膀胱吻合术，以抗尿液逆流；将回肠膀胱近端及输尿管固定于腹膜外，以防腹腔感染。结果：主要并发症有直肠损伤１例、肠梗阻３例、回肠膀胱坏死２例、尿漏２例。结论：Ｂｒｉｃｋｅｒ术是全膀胱切除后作尿流改道较安全、应用较广泛的术式，准确把握手术关键步骤，是预防Ｂｒｉｃｋｅｒ术并发症的要点。
Objective:Complications of total cystectomy and Bricker's operation were summed up in bladder cancer patients and management methods were discussed.Methods:Total cystectomy and Bricker's operation were applied in 76 cases of multiple,relapsing and invasive bladder cancer.Ureter ileum anastomosis was performed to prevent urine reversion along submucous channel,adjacent terminal of ileal conduit was fixed at post peritonaeum to avoid abdominal infection.Results:Complications occurred in 13 patients,rectum injury(1 case),intestine obstruction(3 cases),ileal reservoir necrosis(2 cases),urine leakage(2 cases) and tumor relapse in residual urethra(2 cases).Conclusions:To prevent complications of Bricker's operation,mastered technique for choice of ileal segment,anastomosis of ureter ileum and fixation of ileal conduit was important.Total cystectomy and Bricker's operation have the advantage of safe,and have important clinical value in management of bladder cancer patient.
出处
《蚌埠医学院学报》
CAS
1998年第5期311-312,共2页
Journal of Bengbu Medical College
