Steiner U, Miller K, Hautmann R
Urologische Universitätsklinik Ulm.
Urologe A. 1994 Jan;33(1):53-7.
Between April 1986 and October 1992, a total of 229 patients with invasive bladder cancer underwent radical cystectomy and lower urinary tract reconstruction by means of the ileal neobladder. The perioperative mortality was 2.4%. Subsequently 10.5% of the patients suffered from early complications that led to relaparotomy and 3.8% of the patients had bowel occlusion. Significant late complications were urethro-ileal strictures (6.7%) and stenosis of the ureteral anastomosis (3.3%). Despite a very strict definition of continence, only 2 patients with a follow up of more than 2 years had an incontinence grade 3. Most (77%) of the patients in this collective were perfectly continent day and night, while 11.5% had only occasional spotting and wore pads to be on the safe side. In conclusion, the medium-term results are now available (average follow up 41 months) and show that the ileal neobladder is the treatment of choice for male patients after radical cystectomy for the treatment of invasive bladder cancer.
1986年4月至1992年10月期间,共有229例浸润性膀胱癌患者接受了根治性膀胱切除术,并采用回肠新膀胱进行下尿路重建。围手术期死亡率为2.4%。随后,10.5%的患者出现早期并发症,需要再次剖腹手术,3.8%的患者出现肠梗阻。严重的晚期并发症包括尿道回肠狭窄(6.7%)和输尿管吻合口狭窄(3.3%)。尽管对控尿有非常严格的定义,但只有2例随访超过2年的患者为3级尿失禁。该组大多数患者(77%)日夜完全控尿,而11.5%的患者只是偶尔有少许渗漏,为安全起见使用尿垫。总之,目前已有中期结果(平均随访41个月),表明回肠新膀胱是浸润性膀胱癌男性患者根治性膀胱切除术后的首选治疗方法。