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本组 8例浸润性膀胱癌采用逆行法行全膀胱切除后作改良肠道原位新膀胱术 ,其中 6例用改良乙状结肠原位新膀胱 ,2例用改良回肠原位新膀胱做下尿路重建。输尿管吻合用改良LeDuc和粘膜下隧道法。手术时间 2 40～360min。术中出血量 30 0～ 12 0 0ml,输血 5例 ,输血量 2 0 0～ 40 0ml。术后平均住院 18( 8～ 2 0 )d。平均随访 14 ( 3～ 2 4)个月。全部病人自主排尿 ,6例昼夜完全控尿 ,2例白天完全控尿 ,夜间偶有失禁。肾功能正常 8例 ,电解质正常 7例。改良肠道原位膀胱功能良好 ,是膀胱全切后尿路重建的理想方法之一
The group of 8 cases of invasive bladder cancer using retrograde approach for total cystectomy for modified intestinal neo-bladder surgery, including 6 cases of modified sigmoid colon in situ neovagina, 2 cases with improved ileal neo-bladder in the lower urinary tract reconstruction. Ureteral anastomosis with modified LeDuc and submucosal tunneling. Surgery time 2 40 ~ 360min. Intraoperative blood loss of 30 0 ~ 120ml, blood transfusion in 5 cases, blood transfusion 200 ~ 40 0ml. The average postoperative hospital 18 (8 ~ 20) d. The average follow-up 14 (3 ~ 24) months. All patients with independent urination, 6 cases of complete control of urine day and night, 2 cases of complete control of urine during the day and night, sometimes incontinence. Normal renal function in 8 cases, normal electrolyte in 7 cases. Improved intestinal in situ bladder function is good, is one of the ideal method of urinary tract reconstruction after total bladder resection