摘要
目的探讨膀胱癌根治性全切术中保留前列腺尖部包膜与原位回肠新膀胱术的临床疗效。方法对34例膀胱癌患者行保留前列腺尖部包膜的膀胱全切与原位回肠新膀胱术。术中保留距前列腺尖部约1cm的前列腺包膜及血管神经束。术后对患者进行定期随访,了解患者术后控尿、性功能及瘤控效果。结果所有患者均顺利完成保留前列腺尖部包膜和勃起血管神经束的膀胱根治性切除与原位回肠新膀胱术。手术时间为240～370min,平均273min;术中出血200～800ml,平均385ml。术后随访3～36个月,所有患者均可自主排尿,新膀胱容量250～350ml,残余尿量0～80ml,除1例患者白天控尿良好,夜间少量漏尿外,其余患者均控尿良好。术前阴茎勃起正常23例患者中,术后6个月有10例(43.4%)阴茎勃起正常。术后所有患者均未出现局部及尿道残端复发的现象。术后9个月1例出现肺部转移。结论保留前列腺尖部包膜的术式是以改善尿控为主要目的,在不降低瘤控效果的前提下的一种改良术式。
Objective To present our initial experience and results of the prostatic apical capsule sparing cystectomy with orthotopic ileal neobladder. Methods From May 2002 to December 2008, we performed 34 cases of prostatic apical capsule sparing eystectomy with orthotopic ileal neobladder. The prostatic capsule 1 cm part from the apex and neurovascular bundle were preserved. All patients were followed up and perioperative data, continence, sexual function and oncologic results were recorded. Results All operations were finished suecessfully. The mean operative time was 273 min （240-370 min）, and the mean blood loss was 385 ml （200-800 ml）. All patients were followed up for 3-36 months, the volumes of neobladder were 250-350 ml and the post voiding volumes were 0-80 ml. Only one patient presented with leakage of urine during nighttime. 43.4% （10/23） cases preserved potence 6 months after sugery. No local recurrence was noted, but 1 case had lung metastasis at 9 months after sugery. Conclusions The prostatic apical capsule sparing cysteetomy with orthotopie ileal neobladder can improve the postoperative continence function which not increased the risk of tumor recurrence.
出处
《现代泌尿生殖肿瘤杂志》
2010年第1期4-6,共3页
Journal of Contemporary Urologic and Reproductive Oncology
关键词
膀胱肿瘤
外科手术
控尿
Urinary bladder neoplasms
Operative
Continence
