摘要
目的 :探讨 3种可控性肠代膀胱术的手术方法 ,总结经验 ,逐步完善并推广该手术方法的应用。 方法 :13例患者中 ,10例施行去带可控盲升结肠膀胱术 (阑尾输出道 ) ,2例施行回肠可控膀胱术 (回肠输出道 ) ,1例施行回肠原位新膀胱术。 结果 :术后随访 2个月～ 2年 ,除 1例回肠新膀胱有尿失禁现象外 ,其余 12例均获得了良好的可控性。膀胱容量平均 30 0～ 4 0 0ml,白天 2～ 5h导尿 1次 ,夜间导尿 1～ 2次或夜间留置尿管 ,无插管困难。 1例去带可控盲升结肠膀胱术后 2个月时有一侧输尿管返流 ,1年后自愈。 结论 :(1)去除盲升结肠结肠带后 ,能有效地增加 3倍左右储尿囊容积 ,阑尾输出道可控性确切。 (2 )回肠可控膀胱 (回肠输出道 )亦取得了良好可控性 ,也是一种很好的可控膀胱方法之一。 (3)对合适病例施行回肠原位新膀胱术 ,是很理想的方法 。
Objective: To study operation (technical) methods of three Continent colonic or ileal reservoir and accumulate experiences for simplifying operation. Methods: Thirteen continent colonic or ileal reservoirs were performed from 2000 to 2002. There were ten detinia cecocolic bladders and continent appendicoumbilical stoma, two continent ileal reservoirs and one ileal neobladder. Results: All patients had been followed from 2 months to 2 years, and had good continent effects except one ileal neobladder. The volume of new bladder have reached from 300 to 500 ml. Patients catheterized one time per 2 or 5 hour and one or two times or hold catheter (retain ) in evening. There was no difficulty in this procedures. One patient had incontinence in over flow condition, another had one ureter reflux and cured by itself in one year. The ileal neobladder had completed incontinence. No hydronephrosis was approved by Ivu or B ultrasound in all patients. All patients had no handicap in their life or social communication except one ileal neobladder. Some patients have worked after their health recovery. Conclusions: (1) The detinia cecocolic bladder had good compliances, large volume and low pressures, the appendicoumbilical stoma had reliable continent effect. (2) The continent ileal reservoir also acquired good continence. It was another good method for continent bladder. (3) The ileal neobladder urated via the urethra, So patient had no psychological burden in his life. We considered that it is a better method for some people after the radical cystoprostatectomy if the case was choosed correctly.
出处
《新疆医科大学学报》
CAS
2003年第5期456-458,共3页
Journal of Xinjiang Medical University
关键词
膀胱肿瘤
控尿
尿流改道
bladder neoplasms
continence
urinary diversion
