CAJ | 학술논문

目的评价改良Sigma直肠膀胱术中输尿管单并腔肠吻合的疗效.方法对14例膀胱多发移行细胞癌、1例膀胱腺癌根治性膀胱全切术后患者行改良Sigma直肠膀胱术.折叠25 cm直肠乙状结肠缝合成U形储尿囊,其中输尿管分别单腔与储尿囊吻合5例、双输尿管末端1.5～2.0cm并腔缝合后与储尿囊吻合10例.结果 15例患者控尿良好,无明显水电解质酸碱紊乱,术后15～22 d痊愈出院.13例随访8～24个月,其中输尿管单腔肠吻合4例出现吻合口狭窄、轻～重度肾积水,并腔肠吻合9例未出现肾积水.结论改良Sigma直肠膀胱术创伤小、并发症少,患者可通过肛门括约肌自控排尿,无需配带尿袋或间断导尿,符合生理要求,提高了患者的生活质量;输尿管并腔后吻合口径大,不易发生狭窄等严重并发症.
목적 평개개량Sigma직장방광술중수뇨관단병강장문합적료효.방법 대14례방광다발이행세포암、1례방광선암근치성방광전절술후환자행개량Sigma직장방광술.절첩25 cm직장을상결장봉합성U형저뇨낭,기중수뇨관분별단강여저뇨낭문합5례、쌍수뇨관말단1.5～2.0cm병강봉합후여저뇨낭문합10례.결과 15례환자공뇨량호,무명현수전해질산감문란,술후15～22 d전유출원.13례수방8～24개월,기중수뇨관단강장문합4례출현문합구협착、경～중도신적수,병강장문합9례미출현신적수.결론 개량Sigma직장방광술창상소、병발증소,환자가통과항문괄약기자공배뇨,무수배대뇨대혹간단도뇨,부합생리요구,제고료환자적생활질량;수뇨관병강후문합구경대,불역발생협착등엄중병발증.
Objective To make a comparison of curative effect of 1 and 2 ureters anastomosis in modified sigma operation. Methods Modified sigma operation was used after radical cystectomy in 14 cases of bladder transitional cell carcinoma and 1 case of adenocarcinoma of the bladder.We used a folded suture of 25 cm from the sigmoid colon to make the U-shaped urinary reservoirs to anastomose with the ureters in study group.Among study group,1 ureter was anastomosed with urinary reservoir in 5 cases.In the other 10 cases,1.5-2 cm of the terminal parts of 2 ureters were sutured tI am not sure what the authors mean by "big diamogether and then anastomosed with the urinary reservoir.Results 15 cases obtained good voiding control and no obvious water-electrolyte disturbance occurred.All the patients were cured and discharged within 15 to 22 days.Thirteen cases were followed-up in 8 to 24 month time period.Anastonmtic stenosis and moderate-severe hydronephrosis occurred in 4 cases with 1 ureter anastomosis.No hydronephrosis occurred in the 9 cases with 2 ureters anastomosis.Conclusions Modified sigma operation has the advantages of less injury and fewer complications.The patients can obtain self-control urination by anal sphincter without urine bags or intermittent catheterization,so the life quality of the patients is improved.Modified sigma operation with 2 ureters anastomosis has big diameter and there was a lower incidence of serious complications such as anastomotic stenosis.