CAJ | 학술논문

背景:原位尿流改道在膀胱癌根治术后具有良好的控尿能力,但针对女性膀胱癌患者行原位回肠重建新膀胱和原位乙状结肠重建新膀胱后疗效及随访方面的研究很少.目的:比较女性膀胱癌患者原位回肠和乙状结肠尿流改道的临床疗效.方法:回顾性分析1996至2008年行膀胱癌术后原位回肠尿流改道(回肠组, n=29)和乙状结肠尿流改道(乙状结肠组, n=23)的女性膀胱癌患者的临床资料.比较分析两组患者修复中及修复后的一般情况、尿动力学结果、控尿能力和修复后储尿囊相关并发症等.结果与结论:平均随访时间回肠组57个月,乙状结肠组55个月.两种修复方式术中失血量、术后控尿效果接近,但两组在手术时间、治疗后下床时间、新膀胱容量等方面差异有显著性意义(P <0.05).回肠组治疗后早期及晚期储尿囊相关并发症发生率均高于乙状结肠组.回肠组治疗后储尿囊再发肿瘤2例,乙状结肠组未见发生,说明两种重建方式应用于女性膀胱癌患者疗效均良好.
배경:원위뇨류개도재방광암근치술후구유량호적공뇨능력,단침대녀성방광암환자행원위회장중건신방광화원위을상결장중건신방광후료효급수방방면적연구흔소.목적:비교녀성방광암환자원위회장화을상결장뇨류개도적림상료효.방법:회고성분석1996지2008년행방광암술후원위회장뇨류개도(회장조, n=29)화을상결장뇨류개도(을상결장조, n=23)적녀성방광암환자적림상자료.비교분석량조환자수복중급수복후적일반정황、뇨동역학결과、공뇨능력화수복후저뇨낭상관병발증등.결과여결론:평균수방시간회장조57개월,을상결장조55개월.량충수복방식술중실혈량、술후공뇨효과접근,단량조재수술시간、치료후하상시간、신방광용량등방면차이유현저성의의(P <0.05).회장조치료후조기급만기저뇨낭상관병발증발생솔균고우을상결장조.회장조치료후저뇨낭재발종류2례,을상결장조미견발생,설명량충중건방식응용우녀성방광암환자료효균량호.
BACKGROUND: The orthotopic urinary diversion after radical cystectomy of bladder cancer has good urinary continence. However, there are few reports about the clinical efficacy and fol ow-up of orthotopic ileal neobladder and orthotopic sigmoid neobladder in female bladder cancer patients. OBJECTIVE: To compare the clinical efficacy of orthotopic ileal neobladder and orthotopic sigmoid neobladder in female bladder cancer patients. METHODS: The clinical data of the female patients with bladder cancer who were treated with orthotopic ileal neobladder (ileal group, n=29) and orthotopic sigmoid neobladder (sigmoid group, n=23) from 1996 to 2008 were retrospective analyzed. The intraoperative and postoperative conditions, urodynamics, urinary continence, pouch-related complications of the patients in two groups were compared. RESULTS AND CONCLUSION: The average fol ow-up time was 57 months in the ileal group, and 55 months in the sigmoid group. There was no difference in intraoperative blood loss and postoperative urinary continence between two groups, and there were significance differences in operative time, postoperative out-of-bed activity and the orthotopic neobladder’s capacity between two groups (P < 0.05). The early and late pouch-related complication rates in the ileal group were higher than those in the sigmoid group. In the ileal group, tumor recurred in two patients, and no tumor recurred in the sigmoid group. It indicates that orthotopic ileal neobladder and orthotopic sigmoid neobladder in female patients are both safe and effective to achieve satisfactory clinical outcomes.