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1993年5月～1994年5月,我们对10例膀胱癌患者施行了功能性膀胱重建术,取得了满意效果。 临床资料:本组男8例,女2例;年龄26～69岁。10例均为膀胱移行上皮细胞癌,病理分级以Ⅰ～Ⅲ级为主。双肾分泌功能与排泄功能正常者8例,轻度改变2例。血肌酐、尿素氮正常者8例,轻度改变2例。血钾、钠、氯、二氧化碳结合力均正常,尿培养阴性,排尿前膀胱测压5.10～7.12kPa。 手术方法:常规行根治性膀胱切除术,保留尿道。在距回盲瓣20cm处游离回肠46cm,注入甲硝唑液浸泡30分钟后,关闭两断端。在两断端分别留出8cm,于回肠中段的30cm靠肠系膜缘剪开肠管,对折成U形,用2—0肠线连锁缝合回肠前后壁组成贮尿袋。近端8cm的回肠用近侧的4cm作输尿管吻合,远侧的4cm纵行折叠缝合,并在两端用0.5cm宽尼龙绸布加固,将肠管缩窄,以阻止尿液
From May 1993 to May 1994, we performed functional bladder reconstruction in 10 patients with bladder cancer and achieved satisfactory results. Clinical data: The group of 8 males and 2 females; aged 26 to 69 years. All the 10 cases were bladder transitional cell carcinoma, the pathological grade was mainly Ⅰ ~ Ⅲ. Kidney secretion and excretion were normal in 8 cases, mild changes in 2 cases. Serum creatinine, urea nitrogen normal in 8 cases, mild changes in 2 cases. Potassium, sodium, chlorine, carbon dioxide binding were normal, negative urine culture, urinary bladder pressure before 5.10 ~ 7.12kPa. Surgical methods: conventional radical cystectomy, urethra retained. Ileum lobe 20cm away from the ileum 46cm, metronidazole solution into the soak for 30 minutes, turn off the two ends. In the two ends were set aside 8cm, in the middle of the ileum 30cm by the mesenteric edge of the cut open bowel, folded into a U-shaped, with 2-0 catgut interlocking ileum anterior and posterior wall composed of storage bag. A proximal 8 cm ileum was anastomosed with a proximal 4 cm ureteral fold and a distal 4 cm longitudinal fold was folded and sutured at both ends with a 0.5 cm wide nylon staple to narrow the intestine to prevent urination