低张力回肠袢式乙状结肠新膀胱在尿流改道中的应用

[Application of low tension Roux-y sigmoid neobladder in urine diversion].

作者信息

Xia Wei-mu, Liu Ding-yi, Xu Yu-sheng, Wang Man-qin, Wang Jian, Tang Qi, Zhou Wen-long, Wang Ming-wei

机构信息

Department of Urology, the 184th Hospital of Public Liberation Army, Yingtan 335000, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Jun 15;46(12):926-8.

PMID:19035152

Abstract

OBJECTIVE

To assess the therapeutic effects of low tension, anti-reflux Roux-y sigmoid neobladder.

METHODS

A total of 21 patients (7 male and 14 female) were included, aged 43-87 years. All cases received radical cystectomy and low tension Roux-y sigmoid neobladder procedure for invasive bladder cancer were included in this study. The period of follow-up was from 8 to 79 months (the average was 36 months). Evaluations included urinary flow rate, post voiding residual and filling cystometry.

RESULTS

The mean maximum urinary flow rate, the voiding time and the post voiding residual were 28.1 ml/s (21.4-38.4 ml/s), 17 s(9-28 s) and 0 ml respectively. The cystometric capacity was 480 m1 (350-560 ml). The volume of desire to void was 330 ml (120-410 ml). The bladder pressure was from 14.2 to 18.6 cm H2O (the average bladder pressure was 16.4 cm H2O) at high filling volumes. The maximum voiding pressure was 45.0 cm H2O (23.6-63.4 cm H2O).

CONCLUSIONS

The Roux-y sigmoid neobladder has an adequate capacity at low pressure with a satisfactory continence, and it is an effective method for continent urinary diversion.

摘要

目的

评估低张力抗反流Roux-y乙状结肠新膀胱的治疗效果。

方法

共纳入21例患者（男性7例，女性14例），年龄43 - 87岁。本研究纳入所有因浸润性膀胱癌接受根治性膀胱切除术及低张力Roux-y乙状结肠新膀胱术的病例。随访时间为8至79个月（平均36个月）。评估指标包括尿流率、排尿后残余尿量及膀胱充盈测压。

结果

平均最大尿流率、排尿时间及排尿后残余尿量分别为28.1 ml/s（21.4 - 38.4 ml/s）、17秒（9 - 28秒）及0 ml。膀胱测压容量为480 ml（350 - 560 ml）。排尿意愿容量为330 ml（120 - 410 ml）。高充盈量时膀胱压力为14.2至18.6 cmH₂O（平均膀胱压力为16.4 cmH₂O）。最大排尿压力为45.0 cmH₂O（23.6 - 63.4 cmH₂O）。