原位回腸和乙狀結(jié)腸腸代膀胱術(shù)的臨床療效.pdf

1、新疆醫(yī)科大學(xué)碩士學(xué)位論文原位回腸和乙狀結(jié)腸腸代膀胱術(shù)的臨床療效姓名：李剛申請(qǐng)學(xué)位級(jí)別：碩士專業(yè)：外科學(xué)指導(dǎo)教師：王玉杰201004新疆醫(yī)科大學(xué)醫(yī)學(xué)碩士學(xué)位論文新疆醫(yī)科大學(xué)醫(yī)學(xué)碩士學(xué)位論文—2—ClinicalefficacyofthotopicilealneobladderthotopicsigmoidneobladderPostgraduatestudent:LiGangTut:WangYuJieAbstractObjective:T

2、oevaluatetheclinicalefficacyofthotopicilealneobladderthotopicsigmoidneobladder.Methods:Weretrospectivelyreviewedtheclinicaldataof19patientswhohadundergonethotopicilealneobladder13patientswhohadundergonethotopicsigmoidneo

3、bladderfrom1999to2009.thirtytwopatients(28mails4femails).Themeanagewas59yearsold(range20～77yearsold).Weanalyzedtheoperativeindicationscontraindicationperioperativeconditionurinarycontinenceurodynamicspouchrelatedcomplica

4、tions.Results:Meanoperativetimewas440minutes(range365～565minutes)meanintraoperativebloodlosswas1115.6ml(range400～3500ml)transfusionwasneededin29case.Themeanfollowupwas17.9months(range3～36month).Ofallthe32patients3(9.4%)w

5、erelosttofollowup.Onepatientdiedofcancermetastasistwocasesdiedofnoncancerduringfollowup.20patientsunderwenturodynamictest.Themeanmaximalbladdercapacitywas（37857）mlmeanmaximalflowratewas（14.91.3）mlsmeanresidualurinewas（26

6、8）mlat6months.Thedaytimethenighttimeurinarycontinentratesat6monthspostoperativelywere93.1%(27patients)82.8%(24patients)respectively.Allthepatientsvoidedwithoutdifficulty.Complicationsincludingbowelobstructionin1casebowel

7、obstructionpepticulcerin1caseurineleakageatureteranastomosisin5casesurinaryincontinencein4caseswounddehiscencein1caseurethralstricturein2casesmetabolicacidosisin5casesdilatationofureterin4casesurinebackflowin2cases.werec

8、uredcrectlybyconservativesurgicalmethods.Theoverallshttermlongtermcomplicationrateswere48.3%55.2%.Duringthefollowupnopatientwasdetectedtodeveloprecurrenturethralcarcinoma.Conclusion:thotopicilealneobladdersigmoidneobladd

9、erhavewideindicationsshterrecoverytimesimilartophysiologicalvoidingbothcanachievesatisfactyclinicalresults.Itisrecommendedtobewidelyusedinivecidates.Keywds:Bladder；neoplasms；neobladder；Indications；contraindicationcomplic