Sauter T, Bachor R, Miller K, Frohneberg D, Hautmann R
Fortschr Med. 1989 Sep 10;107(26):552-6.
Radical cystectomy, where necessary combined with systemic chemotherapy, is currently regarded to be the treatment of choice in invasive bladder cancer. Compared with such procedures as colonic or ileal conduit the construction of a continent intestinal bladder substitution is not associated with any higher risks but offers a considerably better quality of life without significantly extending the duration of surgery. Our experience with the ileal-neobladder with non-reflux uretero-intestinal implantation described by LeDuc, and Kock's the thoroughgoing application principles to form a low pressure reservoir for bladder substitution, encouraged us to believe that a good long-term prognosis with respect to renal function can be expected. About 90% of all patients with ileal-neobladder are continent day and night. About half of them have sensory function and are capable of voiding urine completely by abdominal straining. For invasive bladder cancer, therefore, continent bladder substitution must be generally regarded to be the superior alternative to urinary diversion by conduit.
根治性膀胱切除术在必要时联合全身化疗，目前被认为是浸润性膀胱癌的首选治疗方法。与结肠或回肠导管等手术相比，可控性肠道膀胱替代术的风险并不更高，但能显著提高生活质量，且不会显著延长手术时间。我们采用勒迪克描述的回肠新膀胱和非反流输尿管肠植入术，以及科克彻底的应用原则来形成用于膀胱替代的低压储尿囊，这使我们相信可以预期肾功能有良好的长期预后。所有回肠新膀胱患者中约90%白天和夜间都能自控排尿。其中约一半有感觉功能，能够通过腹部用力完全排空尿液。因此，对于浸润性膀胱癌，一般认为可控性膀胱替代术优于导管尿流改道术。
