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从1988年12月到1989年12月,我们对Hautmann手术方法进行改良,在7例男性膀胱肿瘤和1例女性结核性萎缩小膀胱患者作了回肠新膀胱手术。取得了满意的近期效果。其方法是行膀胱全切除或近全切除后将一段40cm长的游离回肠段行对肠系膜缘切开,排列成“U”形并缝制成袋,袋口与残余尿道行间断内翻吻合,输尿管行LeDue方法粘膜沟再植,术后尿流动力学研究证实这种回肠新膀胱其容量接近正常膀胱,充盈时压力保持在2.45kPa(25cm水柱)以下。无逆流及尿失禁,经过一段时期训练,病人不但可自主排尿,无残余尿,且有与正常膀胱极为相似的膀胱充盈感觉,是一种无需腹壁造口重建膀胱或扩大膀胱的手术方法。
From December 1988 to December 1989 we modified the Hautmann procedure to deliver a neo-ileal bladder procedure in seven male bladder tumors and one female tuberculous atrophic vesicle. Satisfied with the recent results achieved. The method is the line of bladder resection or near total resection after a period of 40cm long segment of the free ileum line on the mesenteric margin incision, arranged in a “U” shape and sewn into bags, bag mouth and residual urethra line interrupted anastomosis, Transurethral resection of the mucosal canal with the LeDue method of the ureter followed by postoperative urodynamic studies confirming that the capacity of this new ileal neoplasm is close to that of the normal bladder, with the pressure remaining below 2.45 kPa (25 cm water column) during filling. No adverse current and urinary incontinence, after a period of training, patients not only autonomic urination, no residual urine, and has very similar to the normal bladder filling feeling of the bladder, is a need without abdominal reconstruction of the bladder or bladder expansion surgery.