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采用去管化直肠和乙状结肠(乙状结肠直肠袋)的大陆式尿流改道术

[A continent urinary diversion with a detubularized rectum and sigmoid (sigmo-rectal pouch)].

作者信息

Jarolím L, Babjuk M, Hanus T, Janský M, Skrivanová V

机构信息

Urologická klinika I. LF UK a VFN, Praha.

出版信息

Cas Lek Cesk. 1996 Oct 23;135(20):664-7.

PMID:8998813
Abstract

BACKGROUND

The continent reservoir is an ideal urinary diversion in patients after cystectomy. The artificial closing mechanism construction in these reservoirs is rather complicated and the results are uncertain. The objective of the present work is to assess own experience with a relatively simple rectosigmoid reservoir created by a method described by M. Fisch.

METHODS AND RESULTS

Since 1992 till 1995 the sigma-rectum detubularized reservoir was performed in 30 patients. The intricating bladder cancer was an indication for the operation in 27 patients and the other bladder diseases in 3 patients. The patients age ranged from 18 to 75 years. Diurnal continence was achieved in all 30 patients. 12 of them have to awake during the night to evacuate the reservoir 1 to 3 times.

CONCLUSIONS

Sigma-rectum pouch is a good form of cintinent diversion in such patient, which are not suitable for orthoscopic neobladder because of oncologic limitation or bad general conditions. The patients tolerate the procedure very well, heal and adapt quickly to new evacuating mechanisms.

摘要

背景

对于膀胱切除术后的患者,可控性贮尿囊是一种理想的尿流改道方式。这些贮尿囊的人工闭合机制构建相当复杂且结果不确定。本研究的目的是评估采用M. Fisch所描述方法创建的相对简单的直肠乙状结肠贮尿囊的自身经验。

方法与结果

1992年至1995年期间,对30例患者实施了乙状结肠直肠去管化贮尿囊手术。其中27例患者因复杂性膀胱癌接受手术,3例患者因其他膀胱疾病接受手术。患者年龄在18至75岁之间。所有30例患者均实现日间控尿。其中12例患者夜间需醒来排空贮尿囊1至3次。

结论

对于因肿瘤限制或全身状况不佳而不适合行腹腔镜新膀胱术的患者,乙状结肠直肠贮尿囊是一种良好的可控性尿流改道方式。患者对该手术耐受性良好,愈合快且能迅速适应新的排尿机制。

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