CAJ | 학술논문

目的寻求理想的原位尿流改道术式.方法回顾性分析我院自1986～2005年四种原位肠代膀胱术95例临床资料和随访结果.结果术后随访77例.3个月时回肠袋膀胱在膀胱容量、囊内压及可控率方面优于去带盲升结肠膀胱(P＜0.01),12月后无差别(P＞0.05).保留神经组白天和夜间可控率优于非保留神经组,二者差别有显著意义(P＜0.01).去带盲升结肠膀胱组平均输血量、建囊时间及与囊有关的并发症明显少于回肠袋膀胱组(P＜0.01).去带盲升结肠膀胱组和回肠袋膀胱组术后近远期并发症为(10.0%;l8.4%)和(14.3%;21.4%).结论去带盲升结肠贮尿囊具有手术操作相对简单,并发症少的特点.保留神经膀胱全切原位去带盲升结肠膀胱术可以提高术后控尿功能,是一种较理想的尿流改道术式.
목적 심구이상적원위뇨류개도술식.방법 회고성분석아원자1986～2005년사충원위장대방광술95례림상자료화수방결과.결과 술후수방77례.3개월시회장대방광재방광용량、낭내압급가공솔방면우우거대맹승결장방광(P＜0.01),12월후무차별(P＞0.05).보류신경조백천화야간가공솔우우비보류신경조,이자차별유현저의의(P＜0.01).거대맹승결장방광조평균수혈량、건낭시간급여낭유관적병발증명현소우회장대방광조(P＜0.01).거대맹승결장방광조화회장대방광조술후근원기병발증위(10.0%;l8.4%)화(14.3%;21.4%).결론 거대맹승결장저뇨낭구유수술조작상대간단,병발증소적특점.보류신경방광전절원위거대맹승결장방광술가이제고술후공뇨공능,시일충교이상적뇨류개도술식.
Objective To investigate the therapeutic effects of orthoto picurinary diversion. Methods The clinical data of 95cases of bladder carcinoma who underwent radical cystectomy from 1986 to 2005 were summarized and analyzed. Results Complete follow-up was performed in 77 cases. The capacity,intrareservoir pressure and continence rate of ileal ponch was significicantly different from detenial cecocolon ponch 3 months postoperatively (P ＜ 0.01 ), whereas the differentence became in no significicant 12 months postoperatively (P ＞0.05 ). Continence differed significicantly between nerve-sparing group and non-nerve-sparing group( P ＜0.01 ).The mean operative time and the mean volume of blood loss and complication in detenial cecocolon ponch was lower than that in ileal ponch group (P ＜ 0.01 ). The overall short-term and long-term complication rates in detenial cecocolon were 10.0% and 18.4% ,respectively and as well as 14.3% and 21.4% in ileal ponch. Conclusion Detenial cecocolon ponch had the advantages of easily performing and low complication rate. Nerve-sparing cystectomy was associated with improved urinary continence after orthotopic bladder substitution.