回肠膀胱术与原位回肠新膀胱术临床效果比较-外科学专业论文.docxVIP

Ileal Conduit vs Orthotropic Ileal Neobladder after Radical Cystectomy in Patients with Bladder Cancer： A Clinical Retrospective Study Abstract Objective To compare the clinical effects and surgical early and late complications and quality of life of ileal conduit and orthotropic ileal neobladder in the patients who underwent radical cystectomy. Methods A retrospective review was done on 50 patients with transitional cell carcinoma of bladder after radical cystectomy from 2009 to 2012.24 patients with ileal conduit and 26 patients with orthotopic ileal neobladder.Parameters associated with the general conditions(Gender, age, pathological stage) ， the surgical procedures(amount of bleeding during operation，operative time， the hospital stay)， early and late complications, quality of life were compared between the two groups. Results The two groups of patients in terms of gender, age (55.23 ± 5.29vs58.08 ± 5.96), pathological stage was no significant difference (P 0.05). amount of bleeding during operation (962.50±97.21ml VS 876.33±94.19m1) 、 operative time ((338.62±28.02min VS267.13±31.86 min) 、 the hospital stay (36.62±4.27d VS33.79±3.67d) and between two groups with significance difference（P 0.05）. No demonstrable difference was found in the rate of early complications and the rate of late complications between the two procedures in our study (P 0.05). Conclusion The ileal conduit and orthotopic ileal neobladder are both the more commonly used mode after urinary diversion; both have their advantages and disadvantages. No uniform surgical mode of urinary diversion after cystectomy. However, selecting the appropriate urinary diversion according to the individual condition of the patient may well be the common view in all the urologists, making the most of patients can enjoy a good quality of life. 【Key words】 ileal conduit ; orthotropic ileal neobladder ; urinary diversion 前言 根治性膀胱切除术是治疗 T2～T4a，N0～x，M0 肌层浸润性膀胱癌的标准方 法，而膀胱切除后选择何种尿流改道术式对进一步提高膀胱癌患者的生存率、减 少局部复发和远处转移以及术后