摘要
目的 探讨改良回肠替代原位膀胱尿路重建术治疗膀胱癌T2a～T3aN0M 0期的临床效果。 方法 将 2 5例T2a～T3aN0M0期膀胱癌行膀胱全切后 ,以回肠代膀胱原位尿道吻合。 结果 手术时间平均 (180± 4 0 )min。无严重并发症 ,无围手术期和术后早期死亡。术后平均随访 16 (6～ 4 8)个月 ,无复发。术后早期漏尿 1例 ,经引流后治愈 ;15例发生轻度尿失禁 ,均恢复尿道排尿。膀胱容量平均(4 5 0± 10 0 )ml,剩余尿量平均 (15± 10 )ml。 2例出现高氯血症。 结论 改良回肠原位膀胱术治疗T2a～T3aN0M0期膀胱癌效果好 ,提高了患者术后的生活质量。
Objective To explore the clinical effect of urinary reconstruction by modified orthotopic ileal neobladder in the treatment of bladder carcinoma of stage T2a～T3aN0M0. Methods 25 cases of bladder carcinoma with stage T2a～T3aN0M0 were taken into the study. All cases underwent ileal neobladder urethra anatomosis in situ after total bladder resection. Results The avevage operative time was(180±40)min. It turned out that no perioperative or early postoperative mortality, nor severe early complications occurred.The mean postoperative follow-up time was 16(6～48)months.Urine leakage was observed in one case, who was cured by urine drainage later. Light incontinence was found in 15 cases during early postoperative time. They all achieved urethral micturition. The mean capacity of the neobladder and the mean residual urine volume were(450±100)ml and (15±10)ml respectively. Hyperchloremia occurred in 2 patients and no envidence showed replase during the follow- up period. Conclusions The modified orthotopic ileal neobladder may be a good surgical method in the treatment for bladder carcinoma of stage T2a～T3aN0M0 with satisfactory clinical effect and improved life quality.
出处
《中国现代手术学杂志》
2004年第2期114-116,共3页
Chinese Journal of Modern Operative Surgery
