Kubota Hikaru, Takahashi Satoru, Monzawa Shuichi, Yuasa Nami, Endo Takahito, Miura Tetsuya, Yuen Keiji, Yamashita Masuo
Department of Diagnostic Radiology, Shinko Hospital, 1-4-47 Wakihama-cho, Chuo-ku, Kobe-shi, Hyogo-ken, 651-0072, Japan.
Department of Radiology, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe-shi, Hyogo-ken, 650-0017, Japan.
Abdom Radiol (NY). 2016 Feb;41(2):356-67. doi: 10.1007/s00261-015-0576-8.
Radical cystectomy with urinary diversion is a common urological procedure performed for the treatment of bladder cancer. Numerous surgical procedures have been developed for urinary diversion. Over the past decade, orthotopic neobladder reconstruction has been used frequently for urinary diversion because of its advantageousness in providing patients with a good quality of life compared with other urinary diversion technique. Knowledge of the indication, surgical procedure, and postsurgical anatomy of orthotopic neobladder reconstruction is essential. While the technique has many advantages, multiple postsurgical complications may occur after reconstruction, including urine leakage, bowel obstruction and fluid collection (lymphocele, urinoma, hematoma, and abscess), neobladder rupture, vesicoureteral reflux, hydronephrosis, urinary tract infection, urinary calculi, abdominal incisional hernia, bowel obstruction, intraneobladder tumor, and tumor recurrence. Radiological imaging including multiple modalities such as intravenous urography, cystography, CT, and MRI plays an important role in the postoperative evaluation of patients with orthotopic neobladder reconstruction and is an accurate method for evaluating complications. In addition, knowledge of appearances on multimodal imaging helps clinicians to select the modality required to achieve an accurate diagnosis of each complication and avoid misdiagnosis.
根治性膀胱切除术加尿流改道术是一种常见的泌尿外科手术，用于治疗膀胱癌。目前已经开发出多种尿流改道手术方法。在过去十年中，原位新膀胱重建术因其相比其他尿流改道技术在提高患者生活质量方面的优势而被频繁用于尿流改道。了解原位新膀胱重建术的适应症、手术过程及术后解剖结构至关重要。虽然该技术有许多优点，但重建术后可能会出现多种并发症，包括尿漏、肠梗阻和积液（淋巴囊肿、尿瘤、血肿和脓肿）、新膀胱破裂、膀胱输尿管反流、肾积水、尿路感染、尿路结石、腹部切口疝、肠梗阻、新膀胱内肿瘤和肿瘤复发。包括静脉肾盂造影、膀胱造影、CT和MRI等多种方式的放射学成像在原位新膀胱重建术后患者的评估中起着重要作用，是评估并发症的准确方法。此外，了解多模态成像的表现有助于临床医生选择实现每种并发症准确诊断所需的检查方式，避免误诊。
