Miyake Hideaki, Furukawa Junya, Takenaka Atsushi, Inoue Taka-Aki, Yamanaka Nozomu, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Urol Int. 2010;84(1):34-9. doi: 10.1159/000273463. Epub 2010 Feb 17.
The objective of this study was to review the long-term outcomes of orthotopic neobladder (NB) creation.
This study included 235 Japanese men who underwent NB reconstruction after radical cystectomy and were followed for at least 3 years. The types of NB used in this series were Studer, Reddy, Hautmann and Mainz NB in 136, 51, 32 and 16, respectively.
Early and late complications occurred in 70 and 33 men, respectively. Of the 235 men, 210 could void spontaneously, and day- and nighttime continence were achieved in 189 and 149, respectively. The mean maximal flow rate, voided volume and post-void residual were 15.9 ml/s, 209.6 and 38.0 ml, respectively. SF-36 survey for postoperative quality of life showed no significant differences in 7 of the 8 scale scores between the 235 men and an age-matched control population in Japan. The 5-year overall and cancer-specific survival rates were 71.2 and 75.7%, respectively. There were no significant differences in any parameters examined among the four groups except for post-void residual, which was significantly smaller in the Reddy group than in the other three groups.
The orthotopic NB could generally provide satisfactory outcomes on long-term follow-up, irrespective of the types of NB.
本研究的目的是回顾原位新膀胱（NB）创建的长期结果。
本研究纳入了235名接受根治性膀胱切除术后进行NB重建且随访至少3年的日本男性。本系列中使用的NB类型分别为Studer型、Reddy型、Hautmann型和Mainz型，数量分别为136例、51例、32例和16例。
分别有70名和33名男性发生早期和晚期并发症。在235名男性中，210名能够自主排尿，白天和夜间控尿分别达到189名和149名。平均最大尿流率、排尿量和残余尿量分别为15.9ml/s、209.6ml和38.0ml。术后生活质量的SF-36调查显示，这235名男性与日本年龄匹配的对照人群在8个量表评分中的7个方面无显著差异。5年总生存率和癌症特异性生存率分别为71.2%和75.7%。除残余尿量外，四组之间在任何检查参数上均无显著差异，Reddy组的残余尿量明显小于其他三组。
无论NB的类型如何，原位NB在长期随访中总体上都能提供令人满意的结果。
