Yasuno H, Arakawa S, Matsumoto O, Kamidono S, Yamanaka N
Department of Urology, Kobe University School of Medicine.
Hinyokika Kiyo. 1991 Dec;37(12):1621-5.
Bladder replacement using a detubularized right colonic segment was successfully performed on 22 male patients with bladder cancer after radical cystectomy. There were 10 early postoperative complications and one of them required reoperation. Urodynamic studies, performed on 16 patients, showed a low pressure reservoir at a large capacity without any involuntary spikes in every case. Of the 16 patients, 4 were nocturnally enuretic and 1 was partially continent. The other 11 patients (68.8%) were totally continent and voiding well, except one who was on intermittent self-catheterization. The incidence of urinary reservoir infections in patients treated with colon bladder replacement was investigated in 18 patients. The incidence rate of bacteriuria was 5.6% and the positive rate of pyuria was 27.8%. The detection rate of bacteriuria and pyuria was significantly low in patients after colon bladder replacement. These findings indicate that colon bladder replacement can be an ideal option for selected patients with bladder cancer.
对22例膀胱癌男性患者在根治性膀胱切除术后成功实施了使用去管化右结肠段的膀胱替代术。术后早期有10例并发症,其中1例需要再次手术。对16例患者进行了尿动力学研究,结果显示每个病例的储尿囊压力低、容量大且无任何不自主尖峰。在这16例患者中,4例夜间遗尿,1例部分可控。其他11例患者(68.8%)完全可控且排尿良好,只有1例需要间歇性自我导尿。对18例接受结肠膀胱替代术治疗的患者调查了储尿囊感染的发生率。菌尿发生率为5.6%,脓尿阳性率为27.8%。结肠膀胱替代术后患者的菌尿和脓尿检出率显著较低。这些结果表明,结肠膀胱替代术对于选定的膀胱癌患者可能是一个理想的选择。