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目的:报告2例膀胱癌患者利用盲肠、阑尾组合行下尿路改道重建术。方法:利用阑尾盲肠组合行下尿路改道重建术,新膀胱分别由盲肠及回盲肠制成,阑尾作为输出道,术中通过将阑尾基部缝合至盲肠壁内来加强新膀胱括约肌的功能,并且阑尾输出道经脐引出。结果:术后3～6个月,其膀胱容量分别增至380mL、400mL,膀胱内压分别为25cmH2O、30cmH2O,随访中无尿液返流及肾积水,但一个患者术后患肾盂肾炎。临床证实,该尿流改道术效果佳。结论:临床上阑尾盲肠组合可应用于下尿路重建术,并且阑尾、盲肠交界处功能可在术后测试,术中新膀胱括约肌功能的加强是必要的,该术式术后经阑尾腔内插管容易,且输出道经脐引出方便,术后外观隐蔽美观
OBJECTIVE: To report the use of cecum and appendix combination for reconstruction of lower urinary tract in 2 cases of bladder cancer. METHODS: The lower urinary tract was reconstructed using the appendix cecum group. The new bladder was made from the cecum and ileocecal, and the appendix was used as the outlet channel. The function of the new bladder sphincter was strengthened by suturing the base of the appendix to the cecum wall. The tail of the appendix is exported through the umbilicus. RESULTS: After 3 to 6 months, the bladder capacity increased to 380 mL and 400 mL, respectively. The intravesical pressure was 25 cmH2O and 30 cmH2O. No urine reflux and hydronephrosis were noted during follow-up, but one patient had postoperative pyelonephritis. Clinically confirmed, this urinary diversion surgery works well. Conclusion: Clinical appendix caecum combined can be used in lower urinary tract reconstruction. The function of appendix and cecum junction can be tested after operation. It is necessary to strengthen the function of new bladder sphincter during operation. Intubation is easy, and the output channel is easily drawn through the umbilicus, and the appearance is hidden and beautiful after operation.