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目的:探讨全膀胱切除原位回肠代膀胱术治疗浸润性膀胱肿瘤的临床疗效及术后并发症的预防。方法:回顾性分析南京医科大学第一附属医院泌尿外科2005年1月～2008年3月21例膀胱肿瘤行全膀胱切除原位回肠代膀胱术的临床资料。结果:所有病人均得到满意随访,本组患者除2例外均无瘤存活。手术时间为5.5～7.5h,平均5.9h;术中出血量为150～1200ml,平均为450ml;所有患者术后均能自控排尿,无上尿路积水,代膀胱残余尿量20～80ml,功能状态良好。结论:全膀胱切除原位回肠代膀胱术具有术后代膀胱容量大、内压低、可控性能好等优点,是一种较理想膀胱全切术后的膀胱替代术式。
Objective: To investigate the clinical effect of total cystectomy in situ ileal neobladder in the treatment of invasive bladder cancer and prevention of postoperative complications. Methods: The clinical data of 21 cases of bladder tumor undergoing total cystectomy in situ ileal bladder surgery from January 2005 to March 2008 in Department of Urology, the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Results: All patients were satisfactorily followed up. All the patients except the 2 patients survived without tumor. Surgery time was 5.5 ~ 7.5h, an average of 5.9h; intraoperative blood loss of 150 ~ 1200ml, with an average of 450ml; all patients can be controlled after surgery urinary, upper urinary tract hydronephrosis, on behalf of the bladder residual urine volume 20 ~ 80ml, Functional state is good. Conclusions: Whole cystectomy in situ ileal neobladder has the advantages of large bladder capacity, low internal pressure, good controllability and so on. It is an ideal bladder replacement surgeries after total cystectomy.