目的:评价缩窄回肠可控输出道外支持腹壁可控尿流改道的围手术期及远期并发症发生率及远期控尿效果。方法:对84例患者手术中采用两种方式加强缩窄回肠输出道的控尿能力:①39例通过两条1 cm宽的涤纶补片以500 g拉力将4～5 cm的输出道悬吊于腹直肌下方;②45例以3-0尼龙线将一段4～5 cm连接储尿囊的管状回肠贴合于腹直肌背侧,使输出道在腹直肌与管状回肠之间穿过,固定于腹直肌背侧。结果:本组1例术后55天死于心脏疾病,8例(9.6%)出现围手术期并发症,其中2例(2.4%)需再次手术,其余患者均经对症处理缓解。27例(32.5%)出现术后远期并发症,5例(6.0%)需再次手术纠正。在完成最近一次随访的52例患者中,43例可实现尿控,其中37例可日夜满意控尿。涤纶补片组与额外回肠段组的满意控尿率分别为77.3%和76.9%。结论:虽然缩窄回肠可控输出道外支持腹壁可控尿流改道的并发症仍较常见,但其发生率在可以接受的范围,且大多数并发症的处理都较为简单,再手术的概率并不高。长期随访结果显示该手术可使缩窄回肠输出道获得持久、可靠的控尿能力。 OBJECTIVE: To evaluate the perioperative and long-term complication rates and long-term urinary control efficacy of narrowing ileal controllable output of extra-corporeally controlled abdominally controlled urinary diversion. Methods: 84 cases of patients with surgery to strengthen the ability to narrow the ileum output control of urinary tract: ①39 cases by two 1 cm wide polyester patch to 500 g tension will be 4 ~ 5 cm of output suspension in the Rectus abdominis; 45 cases of 3-0 nylon line will be a 4 ~ 5 cm connected to the storage of the alveolar tubular ileum in the rectus abdominis, the output of the rectus abdominis and tubular ileum through between, Fixed to the dorsolateral rectus abdominis. Results: One patient died of heart disease 55 days after operation. Perioperative complications occurred in 8 patients (9.6%). Two patients (2.4%) required reoperation and other patients were relieved symptomatically. Twenty-seven patients (32.5%) had long-term postoperative complications, and 5 (6.0%) needed reoperation. Of the 52 patients who completed the most recent follow-up, 43 achieved urinary control and 37 were satisfied with urinary control day and night. Satisfactory rate of control over the contaning of the polyester patch group and the additional ileum segment was 77.3% and 76.9%, respectively. CONCLUSIONS: Although the complications of controlled ileal diversion to support controlled urinary diversion outside the ileum are still common, the incidence is within an acceptable range and the treatment of most complications is relatively simple and the probability of reoperation is high not tall. Long-term follow-up results show that the operation can narrow the ileum output tract to obtain long-lasting, reliable urine control.