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[全膀胱切除术后结肠膀胱替代术]

[Colon bladder replacement after total cystectomy].

作者信息

Yamanaka N, Imai T, Miyazaki J, Umezu K, Kawabata G, Ghoji K, Yasuno H, Okada H, Kamidono S

机构信息

Department of Urology, Shinko Hospital.

出版信息

Hinyokika Kiyo. 1989 Apr;35(4):587-91.

PMID:2735264
Abstract

Although ileal conduit diversion is widely accepted in the treatment of the patients undergoing radical cystectomy, many patients would prefer other alternatives which allow continence. and urination through the urethra. We describe a new procedure in which a segment of detuburalized right colon is used as a continent reservoir. Eight patients, 7 after radical cystectomy for bladder cancer and one after total exenteration for rectal cancer, have undergone colon bladder replacement. New created bladder had a capacity of 300 to 600 ml. All patients could pass urine through the urethra but one is on self-catheterization. Five of the 8 patients had no residual urine. Three months after operations 4 were totally continent and 3 were satisfactorily dry during daytime but slightly enuretic. Excretory urography showed no abnormalities in their upper urinary tract. Considering the "quality of life' of a patient, this procedure can be an ideal option for selected patients.

摘要

尽管回肠导管改道术在根治性膀胱切除术患者的治疗中被广泛接受,但许多患者更倾向于其他能实现控尿并经尿道排尿的替代方法。我们描述了一种新手术,即使用一段去管化的右半结肠作为可控性储尿囊。8例患者接受了结肠膀胱替代术,其中7例因膀胱癌行根治性膀胱切除术,1例因直肠癌行全盆腔脏器切除术。新构建的膀胱容量为300至600毫升。所有患者均能经尿道排尿,但有1例需自行导尿。8例患者中有5例无残余尿。术后3个月,4例完全可控,3例白天排尿情况良好,但有轻微遗尿。排泄性尿路造影显示其上部尿路无异常。考虑到患者的“生活质量”,该手术对于特定患者而言可能是理想选择。

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