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背景:原位尿流改道在膀胱癌根治术后具有良好的控尿能力,但针对女性膀胱癌患者行原位回肠重建新膀胱和原位乙状结肠重建新膀胱后疗效及随访方面的研究很少。目的:比较女性膀胱癌患者原位回肠和乙状结肠尿流改道的临床疗效。方法:回顾性分析 1996 至 2008 年行膀胱癌术后原位回肠尿流改道(回肠组,n=29)和乙状结肠尿流改道(乙状结肠组,n=23)的女性膀胱癌患者的临床资料。比较分析两组患者修复中及修复后的一般情况、尿动力学结果、控尿能力和修复后储尿囊相关并发症等。结果与结论:平均随访时间回肠组 57 个月,乙状结肠组 55 个月。两种修复方式术中失血量、术后控尿效果接近,但两组在手术时间、治疗后下床时间、新膀胱容量等方面差异有显著性意义(P < 0.05)。回肠组治疗后早期及晚期储尿囊相关并发症发生率均高于乙状结肠组。回肠组治疗后储尿囊再发肿瘤 2 例,乙状结肠组未见发生,说明两种重建方式应用于女性膀胱癌患者疗效均良好。
BACKGROUND: In situ urinary diversion has good ability to control urinary incontinence after radical mastectomy of bladder cancer. However, few researches have been done on the curative effect and follow-up of reconstructive neo-urinary bladder after orthotopic ileum reconstruction and in situ sigmoid colon reconstruction in women with bladder cancer. Objective: To compare the clinical efficacy of orthotopic ileum and sigmoid urinary diversion in women with bladder cancer. Methods: The clinical data of female bladder cancer patients with bladder transitional cell carcinoma after ileal urinary tract diversion (ileum group, n = 29) and sigmoid urinary diversion (sigmoid colon group, n = 23) between 1996 and 2008 were retrospectively analyzed. Comparative analysis of the two groups of patients after repair and repair of the general situation, urodynamic results, urine control ability and storage-related complications after storage. RESULTS AND CONCLUSION: The average follow-up time was 57 months in the ileum group and 55 months in the sigmoid colon group. The two methods of repair blood loss, the effect of postoperative urine control close, but the two groups in the operation time, bed time after treatment, the new bladder capacity and other differences were significant (P <0.05). The incidence of complications associated with early and late storage of urine in the ileal group was significantly higher than that in the sigmoid colon. In the ileal group, there were 2 cases of recurrent tumor in the storage vessel, and no sigmoid colon occurred, indicating that the two reconstruction methods were effective in treating bladder cancer in women.