Lopatkin N A, Mazo E B, Vartanyan O K
Int Urol Nephrol. 1976;8(2):113-20. doi: 10.1007/BF02082206.
Evidence is presented concerning 94 patients with malignancy of bladder in whom diversion of urine was performed after cystectomy for exclusion of the bladder. There were 80 men and 14 women, ages ranging from 30 to 81 years. In 35 of these 94 cases ureterosigmoidoanastomosis, in 38 cases ureterocutaneostomy, in 15 Portilla's operation, in 2 Bricker's method and in 4 nephro-pyelostomy were performed. For the prevention of bleeding cystectomy was preceded by bilateral ligation of the internal iliac artery in 14 cases. Continuous postoperative follow-up of the patients (from a few months to 14 years) and analysis of the early and late results allow to regard the combined technique of Coffey II-Nesbit-Goodwin as the method of choice having the slightest risk of peritonitis, intestinoureteral reflux and other complications inherent in other procedures. Of the existing methods of ureterocutaneostomy the authors have chosen Le Dentu's method with some modifications. They consider ureterostomy to be the simplest and quickest method owing to the higher location of ureterostoma. Portilla's method is no longer used because of its unfavourable long-term results. Of 94 patients with cancer of the bladder, who had been subjected to different methods of urinary diversion in the years 1954-1974, 16 have survived up till now. There are 10 survivors after ureterosigmoidoanastomosis, 5 after ureterocutaneostomy and 1 after Bricker's operation.
本文提供了94例膀胱恶性肿瘤患者的相关证据，这些患者在膀胱切除术后进行了尿液改道以排除膀胱。其中男性80例，女性14例，年龄在30至81岁之间。在这94例病例中，35例行输尿管乙状结肠吻合术，38例行输尿管皮肤造口术，15例行波蒂拉手术，2例行布里克手术，4例行肾盂造瘘术。为预防出血，14例在膀胱切除术前行双侧髂内动脉结扎。对患者进行连续的术后随访（从几个月到14年）并分析早期和晚期结果后发现，科菲二世-内斯比特-古德温联合技术是首选方法，其发生腹膜炎、肠输尿管反流及其他手术固有并发症的风险最小。在现有的输尿管皮肤造口术方法中，作者选择了经过一些改良的勒丹图方法。他们认为输尿管造口术是最简单、最快的方法，因为输尿管造口位置较高。由于波蒂拉手术长期效果不佳，已不再使用。在1954年至1974年间接受不同尿液改道方法治疗的94例膀胱癌患者中，至今有16例存活。输尿管乙状结肠吻合术后有10例存活，输尿管皮肤造口术后有5例存活，布里克手术后有1例存活。
