目的:评价改良直肠乙状结肠代膀胱术治疗小儿完全性膀胱外翻的疗效。方法:对3例年龄较大完全性膀胱外翻患儿行改良直肠乙状结肠代膀胱尿流改道术,将改良Duhamel式巨结肠根治术张氏环钳用于肠管吻合,下腹部腹壁缺损采用局部腹壁皮瓣修复,术后随访1年~8年。结果:3例手术均顺利完成,手术时间平均3小时(2.5~4.5小时);术后住院时间平均18天(16~24天),出院时腹直肌皮瓣均完全覆盖耻骨上腹壁缺损,外观良好。术后随访3例患者大小便控制良好,并发症少,明显提高了患儿生活质量。结论:对年龄较大的完全性膀胱外翻患儿,其外翻膀胱已挛缩,瘢痕化明显,膀胱收缩性能差,失去膀胱闭合时机,改良直肠乙状结肠代膀胱术是一种可选用的手术方式,且疗效可靠,值得推广。 Objective: To evaluate the efficacy of modified rectosigmoid neobladder in the treatment of pediatric complete bladder eversion. Methods: Three cases of children with complete urinary bladder eversion underwent modified sigmoid colon debridement and bladder urinary diversion. The modified Duhamel-type megacolon radical gastrectomy was used for bowel anastomosis. The abdominal wall of the lower abdomen was treated with local abdominal wall Flap repair, follow-up 1 year to 8 years. Results: The operation was completed successfully in 3 cases. The average operation time was 3 hours (2.5-4.5 hours). The average postoperative hospital stay was 18 days (16-24 days). All the flaps of the rectus abdominis muscle completely covered the suprapubic abdomen defect, Looks good. Postoperative follow-up 3 cases of patients with good toilet control, fewer complications, significantly improve the quality of life of children. Conclusion: For older children with complete bladder eversion, the valgus bladder has contracture, obvious scarring, poor bladder contractility, missed bladder timing and modified sigmoid colon debridement are an alternative surgical procedure , And reliable, it is worth promoting.