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目的:探讨应用端端插入式技术对输尿管回肠膀胱进行吻合的临床有效性。方法:回顾性分析我院2011年5月~2015年12月47例行腹腔镜下根治性膀胱切除+回肠膀胱术患者的临床资料,男31例,女16例,平均年龄64.4岁。手术尿流改道过程中采用端端插入式技术吻合输尿管与回肠。术后针对肾脏积水及程度、吻合口狭窄、吻合口瘘等主要并发症指标进行相关随访分析。结果:本组47例手术均顺利完成。术后随访10~63个月,平均36个月,无吻合口瘘病例,肾积水、吻合口狭窄、回肠膀胱结石、泌尿系感染及肾功能异常的发生率分别为6.4%(3/47)、4.3%(2/47)、2.1%(1/47)、4.3%(2/47)及8.5%(4/47)。结论:采用端端插入式技术进行吻合效果确切,术后相关并发症少,且处理起来更简易、便捷、可靠。
Objective: To investigate the clinical efficacy of end-insert technique in ureteral ileal urinary bladder anastomosis. Methods: The clinical data of 47 patients undergoing laparoscopic radical cystectomy + ileal blast surgery from May 2011 to December 2015 in our hospital were retrospectively analyzed. There were 31 males and 16 females, with an average age of 64.4 years. Surgery urinary diversion process using end-inserted technology consistent ureter and ileum. Follow-up analysis was performed on major complications such as hydronephrosis and anastomotic stricture and anastomotic fistula after operation. Results: All the 47 cases in this group were successfully completed. The patients were followed up for 10 to 63 months with an average of 36 months. The incidences of anastomotic leakage, hydronephrosis, anastomotic stenosis, ileal bladder stones, urinary tract infection and renal dysfunction were 6.4% (3/47 ), 4.3% (2/47), 2.1% (1/47), 4.3% (2/47) and 8.5% (4/47) respectively. Conclusion: The anastomosis with end-point insertion technique is effective, with fewer postoperative complications and easier to handle, more convenient and more reliable.