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目的:总结全膀胱切除术后改良原位回肠新膀胱术的临床疗效。方法:2005年11月～2007年6月对11例全膀胱切除术后行改良的原位新回肠膀胱术:膀胱全切除采用顺行逆行相结合的方法;带蒂末段回肠一部分为新膀胱输入道,另一部分为回肠片经折叠后缝合成类球形新膀胱,输尿管以匙形吻合种植于新膀胱输入道上,类球形新膀胱底部与后尿道端吻合。结果:围手术期无1例死亡,平均手术时间为4h,术中平均出血量300ml;术后随访5～24个月,平均14个月,11例白天均能控尿,夜尿2～3次,无遗尿。结论:全膀胱切除术后改良原位回肠新膀胱外形接近膀胱形态,符合生理排尿;是治疗浸润性膀胱癌首选方案之一。
Objective: To summarize the clinical effect of modified ileal neobladder after total cystectomy. Methods: From November 2005 to June 2007, 11 patients with modified neo-ileal bladder after total cystectomy were treated by retrograde retrograde cystectomy. Enter the tract, the other part of the ileum after sutured into a class of spherical neovascularization, ureteral spigot-shaped anastomosis implanted in the new bladder input tract, the bottom of the spheroidal neovasculature consistent with the urethral end. Results: No perioperative death occurred in 1 case, the average operation time was 4 hours and the average blood loss was 300ml. The patients were followed up for 5-24 months with an average of 14 months. In the 11 cases, urine was controlled during the day and nocturia was 2-3 Times, without enuresis. Conclusions: The modified ileal neo-bladder shape after cystectomy approaches the shape of bladder, which is in line with physiological urination. It is one of the first choice for the treatment of invasive bladder cancer.