Da Pozzo L F, Colombo R, Pompa P, Montorsi F, Di Girolamo V, Rigatti P
Department of Urology, Scientific Institute H. S. Raffaele, Milan, Italy.
J Urol. 1994 Nov;152(5 Pt 1):1409-12. doi: 10.1016/s0022-5347(17)32432-1.
During the last 6 years 24 sigmoid colon neobladders were constructed at our institute according to a surgical technique that provides for an optimal spherical configuration of the orthotopic reservoir. All patients underwent radical cystectomy for locally advanced or superficial recurrent bladder cancer. The surgical complication rate was minimal. Mean followup was 38.3 months (range 7 to 70). Patients were evaluated at 9 and 18 months with urodynamic tests. Daytime continence was achieved in 20 of 21 (95.2%) and in 16 of 17 (94.1%) patients, respectively. Nocturnal incontinence was noted in 9 of 21 (42.8%) and 5 of 17 (29.4%) patients. The mean neobladder capacity was 414 cc and 492 cc, respectively. Endoluminal pressure at the maximum reservoir capacity was 31 cm. water (range 23 to 54) and this did not change significantly at 18 months. Minimal post-voiding residual volume was evidenced in all but 1 patient and was maintained at 18 months. Our modified sigmoid colon neobladder is an easy surgical procedure that provides satisfactory total bladder replacement in select patients.
在过去6年中，我们研究所根据一种能使原位贮尿囊呈最佳球形构型的手术技术构建了24个乙状结肠新膀胱。所有患者均因局部进展性或浅表复发性膀胱癌接受了根治性膀胱切除术。手术并发症发生率极低。平均随访时间为38.3个月（范围7至70个月）。在9个月和18个月时对患者进行尿动力学检查评估。分别有21例患者中的20例（95.2%）和17例患者中的16例（94.1%）实现了日间控尿。21例患者中有9例（42.8%）、17例患者中有5例（29.4%）存在夜间尿失禁。新膀胱平均容量分别为414 cc和492 cc。贮尿囊最大容量时的腔内压力为31 cm水柱（范围23至54），且在18个月时无显著变化。除1例患者外，所有患者排尿后残余尿量极少，且在18个月时维持这一状态。我们改良的乙状结肠新膀胱手术操作简便，能为部分患者提供令人满意的全膀胱替代。
