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目的:评价膀胱全切原位尿流改道术治疗膀胱非尿路上皮癌的疗效。方法:对17例膀胱非尿路上皮癌患者行根治性膀胱全切,盆腔淋巴结清扫;然后取一段肠管缝制成新膀胱,分别与输尿管和尿道残端吻合,实现原位尿流改道。结果:手术均获成功,手术时间172～380 min,平均310min。16例获得随访,平均随访67个月(1～16年)。6例因肿瘤复发或转移于5年内死亡,2例死于非肿瘤因素,1例仍在随访,7例存活已达5年。结论:根治性膀胱全切原位尿流改道术治疗膀胱非尿路上皮癌,具有较好的治疗效果,能明显改善患者生活质量。
Objective: To evaluate the effect of total cystectomy in situ urinary diversion on bladder non-urothelial carcinoma. Methods: Seventeen cases of bladder urothelial carcinoma were treated by radical cystectomy and pelvic lymphadenectomy. Then a section of intestine was sewn into a new bladder and anastomosed to the ureter and urethral stump, respectively, to achieve the in situ urinary diversion. Results: All the operations were successful. The operation time ranged from 172 to 380 minutes with an average of 310 minutes. Sixteen patients were followed up for an average of 67 months (range 1 to 16 years). 6 cases died of tumor recurrence or metastasis within 5 years, 2 died of non-tumor factors, 1 case was still followed up and 7 cases survived for 5 years. CONCLUSION: Radical curative bladder resection in situ urinary diversion for the treatment of bladder non-urothelial carcinoma has good therapeutic effect and can significantly improve the quality of life of patients.