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用尿道科克氏囊替代膀胱:功能结果、尿动力学及放射学特征

Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features.

作者信息

Kock N G, Ghoneim M A, Lycke K G, Mahran M R

机构信息

Institute of Urology and Nephrology, University of Mansoura, Egypt.

出版信息

J Urol. 1989 May;141(5):1111-6. doi: 10.1016/s0022-5347(17)41185-2.

DOI:10.1016/s0022-5347(17)41185-2
PMID:2709496
Abstract

After cystoprostatectomy for cancer of the bladder 43 men were provided with a detubularized, low pressure ileal reservoir (Kock pouch) connected to the urethra. Reflux was prevented by an intussusception valve. There was no operative mortality and few early complications. At followup the mean postoperative observation time was 13 months, with a range of 5 to 20 months. Late complications included manifestations of local tumor recurrence or distant metastases in 9 patients within 6 months postoperatively, which made adequate functional evaluation impossible. In 18 patients reflux to the upper urinary tract due to eversion or sliding of the antireflux valve occurred at various postoperative intervals. In 16 of these patients incontinence developed as a consequence of the reflux. Surgical correction of the failing antireflux valve restored reflux prevention and continence. Within 3 to 6 months the capacity of the reservoirs had reached an ultimate volume of approximately 600 ml. Pressure waves exceeding 40 cm. water seldom occurred in the mature reservoirs and then only at high filling volumes. The mean urethral resting resistance to flow was 64 cm. water. The configuration and function of the upper urinary tract improved or stabilized postoperatively. Of 34 evaluable patients 30 were continent during the day with a voiding frequency of 3 to 5 times and dry at night with a frequency of 0 to 2.

摘要

43名男性因膀胱癌接受膀胱前列腺切除术后,被植入了一个去管化、低压的回肠储尿囊(科克袋),并与尿道相连。通过套叠瓣膜防止尿液反流。无手术死亡病例,早期并发症也很少。随访时,术后平均观察时间为13个月,范围为5至20个月。晚期并发症包括9例患者在术后6个月内出现局部肿瘤复发或远处转移的表现,这使得无法进行充分的功能评估。18例患者在术后不同时间段因抗反流瓣膜翻转或滑动出现上尿路反流。其中16例患者因反流出现尿失禁。对功能失效的抗反流瓣膜进行手术矫正后,恢复了防反流和控尿功能。3至6个月内,储尿囊的容量达到约600毫升的最终体积。成熟储尿囊中很少出现超过40厘米水柱的压力波,且仅在高充盈量时出现。尿道静息流阻平均为64厘米水柱。上尿路的形态和功能在术后得到改善或稳定。在34例可评估患者中,30例白天能自主排尿,排尿频率为3至5次,夜间干爽,频率为0至2次。

相似文献

1
Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features.用尿道科克氏囊替代膀胱:功能结果、尿动力学及放射学特征
J Urol. 1989 May;141(5):1111-6. doi: 10.1016/s0022-5347(17)41185-2.
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An appliance-free, sphincter-controlled bladder substitute: the urethral Kock pouch.一种无器械、括约肌控制的膀胱替代物:尿道Kock贮袋。
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Clinical experience of Kock pouch continent urinary diversion.Kock回肠膀胱术的临床经验
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Kock to urethra: continent functional bladder replacement.科克氏尿道术:可控性功能性膀胱替代术。
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[Indiana continent urinary reservoir: report of 15 cases].[印第安纳洲可控性膀胱术:15例报告]
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Experience in 100 patients with an ileal low pressure bladder substitute combined with an afferent tubular isoperistaltic segment.100例回肠低压膀胱替代联合传入段等蠕动节段的经验。
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[Bladder replacement by entero-cystoplasty after radical cystectomy for bladder cancer--the urethral Kock pouch].[膀胱癌根治性膀胱切除术后采用肠膀胱扩大术进行膀胱替代——尿道Kock袋]
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[The ileal neobladder].
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引用本文的文献

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THE ILEAL NEOBLADDER - AN IDEAL BLADDER SUBSTITUTE?回肠新膀胱——一种理想的膀胱替代物?
Med J Armed Forces India. 1996 Apr;52(2):67-70. doi: 10.1016/S0377-1237(17)30845-6. Epub 2017 Jun 26.
2
Outcomes of a bladder preservation technique in female patients undergoing pelvic exenteration surgery for advanced gynaecological tumours.晚期妇科肿瘤盆腔廓清术女性患者膀胱保留技术的疗效
Int Urogynecol J. 2014 Jul;25(7):953-60. doi: 10.1007/s00192-014-2341-x. Epub 2014 Mar 15.
3
Bladder replacement in women: a new experience.女性膀胱置换:一种新体验。
Int Urogynecol J Pelvic Floor Dysfunct. 1997;8(1):36-46. doi: 10.1007/BF01920292.
4
Optimization of uretero-intestinal anastomosis in urinary diversion: an experimental study in dogs. III. A new antireflux technique for uretero-ileal anastomosis: a serous-lined extramural tunnel.尿流改道中输尿管-肠道吻合术的优化:犬实验研究。III. 输尿管-回肠吻合术的一种新抗反流技术:带浆膜的壁外隧道
Urol Res. 1993 Mar;21(2):135-9. doi: 10.1007/BF01788833.
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Anterior pelvic reconstruction with ileum after cancer treatment.癌症治疗后用回肠进行骨盆前部重建。
J R Soc Med. 1991 Dec;84(12):709-13. doi: 10.1177/014107689108401206.