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尿流改道手术力求使病人接近生理性排尿,原位新膀胱手术(OrthotopicNeobladder)近年来得到迅速发展。任何行膀胱根治性切除的病人都有可能行原位新膀胱术,在选择病人时应考虑疾病分期、全身情况、本人意愿及依从性等。原位新膀胱在选材时既应考虑到所选材料对机体的生理影响,又应考虑到新膀胱的功能情况。目前最为常用的原位回肠新膀胱手术方式主要有Hautmann术式、Studer术式、半Kock新膀胱、T型回肠新膀胱。原位新膀胱较其他尿流改道术有很多优越性,但标准的膀胱癌根治术加上原位新膀胱术是一个复杂的手术,有一定的并发症和死亡率,而且,原位新膀胱是再造的膀胱,在储尿、排尿及控尿方面存在着这样那样的问题。
Urinary diversion surgery to make patients close to physiological urination, in situ neobladder (OrthotopicNeobladder) has been rapid development in recent years. Any patient who has undergone radical resection of the bladder has the potential to perform neobladder surgery in situ. In selecting patients, the staging of the disease, general condition, my wishes and compliance should be considered. In situ selection of the new bladder should take into account the selected material on the body’s physiological effects, but also should take into account the function of the new bladder. Currently the most commonly used ileal neo-bladder surgery are mainly Hautmann operation, Studer operation, half Kock neobladder, T-type ileum neo-bladder. In situ neoplasms have many advantages over other urinary diversions, but standard neoplasms of bladder cancer plus neo-neobladder in situ are a complex procedure with some complications and mortality. Moreover, neobladder in situ It is a reconstructed bladder that has such problems with urine storage, urination and urine control.