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[回肠新膀胱术治疗膀胱癌的临床经验]

[Clinical experience of ileal neobladder for bladder cancer].

作者信息

Miyoshi S, Iwasaki A, Inoue H, Tsukikawa M, Oka D, Takao T, Mizutani S

机构信息

Department of Urology, Osaka Rosai Hospital.

出版信息

Hinyokika Kiyo. 1998 Jan;44(1):7-11.

PMID:9503200
Abstract

Between June 1993 and July 1996, an ileal neobladder was created in 20 patients after total cystectomy for bladder cancer. The mean post operative follow-up period was 32 months, with a range of 9 to 47 months. Ureteroileostomy was performed using the Le Duc-Camey procedure. There were 3 (15%) early postoperative complications, which were all of transient urine leakage from the neobladder. Late complications were encountered in 6 patients (30%), which were of stenosis of ureteroileal anastomosis in 2 (10%), stone in the neobladder in 2 (10%), neobladder-cutaneous fistula in 1 (5%) and neobladder-ureteral reflux in 1 (5%). Reoperation was necessary in 4 patients (20%); 2 for stenosis of ureteroileal anastomosis and 2 for removal of a stone in the neobladder. No urethral recurrence has been noted. Local recurrence occurred in 2 patients, who died of tumor progression 16 and 27 months postoperatively. All 20 patients were continent during the day time (100%), while 2 (10%) had nocturnal incontinence.

摘要

1993年6月至1996年7月期间,20例膀胱癌患者在全膀胱切除术后接受了回肠新膀胱术。术后平均随访期为32个月,范围为9至47个月。采用Le Duc - Camey手术进行输尿管回肠吻合术。术后早期并发症有3例(15%),均为新膀胱短暂性尿液渗漏。6例患者(30%)出现晚期并发症,其中输尿管回肠吻合口狭窄2例(10%),新膀胱结石2例(10%),新膀胱皮肤瘘1例(5%),新膀胱输尿管反流1例(5%)。4例患者(20%)需要再次手术;2例因输尿管回肠吻合口狭窄,2例因取出新膀胱结石。未发现尿道复发。2例患者出现局部复发,分别在术后16个月和27个月死于肿瘤进展。所有20例患者白天均能自控排尿(100%),而2例(10%)有夜间尿失禁。

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