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目的探讨膀胱全切原位W形回肠代膀胱术临床应用及疗效。方法2005年6月至2008年10月间本院采用膀胱全切原位W形回肠代膀胱术治疗61例膀胱肿瘤患者临床资料进行总结分析。结果手术均成功,手术时间9～13 h,术中失血200～1200 ml,平均650 ml。术后未发现尿瘘肠瘘,肠粘连切口和盆腔感染术后随访6～28个月,平均15个月。术后3个月无输尿管扩张及肾积水,新膀胱形态良好。3例混合性癌及1例鳞癌和腺癌患者,在术后8～17个月后因肿癌转移死亡,其余58例均无瘤生存。结论膀胱全切原位W形回肠代膀胱术,手术简单,术后并发症少,复发少,术后性功能的恢复良好,尿失禁少,代膀胱贮尿排尿功能良好,无全身电解质紊乱,患者的生活质量满意。
Objective To investigate the clinical application and curative effect of total bladder incision in situ W-shaped ileal neobladder. Methods From June 2005 to October 2008, the clinical data of 61 patients with bladder cancer underwent total bladder resection in situ W-shaped ileum for bladder surgery were analyzed. Results The operation was successful. The operation time was 9-13 h. The intraoperative blood loss was 200-1200 ml with an average of 650 ml. No postoperative fistula fistula, intestinal adhesions and pelvic infection were followed up for 6 to 28 months, an average of 15 months. 3 months after ureter dilation and hydronephrosis, the new form of good bladder. Three patients with mixed carcinoma and one patient with squamous cell carcinoma and adenocarcinoma died of tumor metastasis 8 to 17 months after operation. The remaining 58 patients were tumor-free. Conclusion The total bladder incision in situ W-shaped ileal bladder surgery, simple surgery, fewer postoperative complications, fewer recurrences, good recovery of sexual function, less urinary incontinence, bladder urination urinary function is good, no electrolyte imbalance, The patient’s quality of life is satisfactory.