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目的:探讨传统全膀胱根治术及改良保留部分前列腺包膜全膀胱切除术对浸润性膀胱癌的疗效。方法:收集2000年1月～2006年1月膀胱癌行根治性全膀胱切除术45例,男性,平均年龄59岁,26例行传统全膀胱切除术,19例行改良保留部分前列腺包膜全膀胱切除术,随访观察手术效果及生活质量。结果:术后病理报告T2aN0M026例,T2bN0M016例,T3aN0M03例。平均随访39个月,改良组无瘤生存19例,传统组无瘤生存23例,带瘤生存1例,死亡2例。改良组及传统组白天控尿率分别为100%和73%,夜间尿失禁10%和50%。改良组术后81%保留勃起功能,传统组仅14.3%。全部患者储尿囊容量350～480ml,充盈压13～25cmH2O,残余尿量10～60ml。结论:对有选择的病例行保留部分前列腺包膜的全膀胱切除原位回肠新膀胱术可以更好地保留勃起和控尿功能。
Objective: To investigate the curative effect of traditional radical cystectomy and modified partial cystectomy on invasive bladder cancer. Methods: From January 2000 to January 2006, 45 cases of radical cystectomy for bladder cancer were collected. The average age was 59 years. 26 cases underwent traditional total cystectomy and 19 cases underwent modified total cystectomy. Cystectomy was followed up to observe the effect and quality of life. Results: Postoperative pathology T2aN0M026 cases, T2bN0M016 cases, T3aN0M03 cases. The patients were followed up for an average of 39 months. There were 19 cases without disease in the improved group, 23 cases with no tumor in the traditional group, 1 case with tumor survival and 2 cases died. During the daytime, the rate of daytime control in the modified group and the traditional group were 100% and 73% respectively, and nighttime incontinence was 10% and 50% respectively. In the modified group, 81% retained erectile function after operation, compared with 14.3% in the conventional group. All patients storage capacity of 350 ~ 480ml storage, filling pressure 13 ~ 25cmH2O, residual urine volume 10 ~ 60ml. CONCLUSIONS: A total cystectomy with reserved prostatic envelopes in selected patients with neointima of the ileocecal bladder can better preserve erectile function and urine control.