膀胱肿瘤根治性膀胱切除术后的乙状结肠原位新膀胱：印度的经验。
Sigmoid orthotopic neobladder after radical cystectomy for bladder tumour: an Indian experience.
作者信息
Yadav Sher Singh, Sadadukhi Trilok Chand, Sharma Krishnan Kumar, Yadav Ram Gopal, Mathur Rajeev
机构信息
Department of Urology, S.M.S. Medical College, Jaipur, Rajasthan, India.
出版信息
BJU Int. 2007 Feb;99(2):403-6. doi: 10.1111/j.1464-410X.2006.06541.x. Epub 2006 Oct 11.
OBJECTIVE
To determine the long-term results of constructing a sigmoid neobladder after radical cystectomy for transitional cell carcinoma (TCC) of the urinary bladder.
PATIENTS AND METHODS
The study included 170 patients with TCC of the bladder and a normal sigmoid colon. After radical cystectomy the neobladder was formed by completely detubularizing an isolated sigmoid colon segment. Subsequently patients were followed by clinical, biochemical, radiological and urodynamic assessments.
RESULTS
Four patients died soon after surgery; the neobladder-related delayed complications were death in three patients, loss of five renal units, and electrolyte imbalance in five patients. Uretero-intestinal anastomotic narrowing was another frequent delayed complication. Most (97%) patients had nocturnal incontinence, and most voided with a good stream with a minimal postvoid residual urine volume.
CONCLUSION
The sigmoid neobladder, despite some limitations, is the best option for diverting urine after radical cystectomy.
目的
确定膀胱移行细胞癌（TCC）根治性膀胱切除术后构建乙状结肠新膀胱的长期效果。
患者与方法
该研究纳入了170例膀胱TCC且乙状结肠正常的患者。根治性膀胱切除术后，通过将一段孤立的乙状结肠完全去管状化形成新膀胱。随后对患者进行临床、生化、放射学和尿动力学评估。
结果
4例患者术后不久死亡；与新膀胱相关的延迟并发症包括3例死亡、5个肾单位丧失以及5例电解质失衡。输尿管 - 肠道吻合口狭窄是另一种常见的延迟并发症。大多数（97%）患者有夜间尿失禁，且大多数排尿通畅，残余尿量极少。
结论
尽管存在一些局限性，但乙状结肠新膀胱仍是根治性膀胱切除术后尿液改道的最佳选择。
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