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ileal orthotopic
相关语句
  原位回肠
     Ileal orthotopic neobladder(Report of 25 cases)
     原位回肠代膀胱术的疗效观察(附25例报告)
短句来源
     A modified technique of total cystectomy and ileal orthotopic neobladder(report of 25 cases)
     改良原位回肠代膀胱术(附25例报告)
短句来源
     The modified technique of total cystectomy and ileal orthotopic neobladder for bladder tumor(Report of 12 cases)
     改良全膀胱切除原位回肠新膀胱术治疗膀胱癌的临床疗效(附12例报告)
短句来源
     Purpose:To present a 7 year experience with ileal orthotopic neobladders.
     目的 :观察 7年来行原位回肠代膀胱术的治疗效果。
短句来源
     Purpose:To evaluate the modified technique of total cystectomy and the clinical effect of ileal orthotopic neobladder for bladder tumor.
     目的 :评价改良全膀胱切除方法和原位回肠新膀胱术的临床疗效。
短句来源
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  回肠
     Ileal orthotopic neobladder(Report of 25 cases)
     原位回肠代膀胱术的疗效观察(附25例报告)
短句来源
     A modified technique of total cystectomy and ileal orthotopic neobladder(report of 25 cases)
     改良原位回肠代膀胱术(附25例报告)
短句来源
     Continent urinary diversion and ileal orthotopic neobladder (report of 68 cases)
     可控性膀胱术与回肠新膀胱术(附68例报告)
短句来源
     The modified technique of total cystectomy and ileal orthotopic neobladder for bladder tumor(Report of 12 cases)
     改良全膀胱切除原位回肠新膀胱术治疗膀胱癌的临床疗效(附12例报告)
短句来源
     Radical cystectomy with ileal orthotopic neobladder:report of 15 cases
     膀胱全切回肠原位代膀胱15例疗效观察
短句来源
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  ileal orthotopic
We report 8 female patients with ileal orthotopic neobladders after cystectomy.
      
Ileal orthotopic neobladder in women: The first experiences from Turkey and our modifications
      
Dilatation of the upper urinary tract after ileal orthotopic bladder substitution is a frequent finding on the 5-min, 20-min, and 60-min films during the early postoperative period but is found only on the 20-min film 1 year and later after surgery.
      
Intravenous urograms (IVUs) performed preoperatively and at regular intervals postoperatively on 87 long-term survivors (minimum survival, 5 years) following ileal orthotopic bladder substitution were reviewed.
      
The aim of this study was to evaluate the appearance of the upper urinary tract following cystectomy and ileal orthotopic bladder substitution.
      
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Purpose:To present a 7 year experience with ileal orthotopic neobladders.Methods:An neobledder was constructed using an ileal segment with a“W” type. 23 of 25 cases of ileal neobladders have been followed up for 2 to 84 months with a mean of 24 months.Results:Operating time ranged from 150 to 310 minutes with a mean of 240 minutes.1 died of cancer metastasis. All patients were satisfactory with the operation except 3 cases. 23 patients achieved excellent daytime continent, while only 14 had...

Purpose:To present a 7 year experience with ileal orthotopic neobladders.Methods:An neobledder was constructed using an ileal segment with a“W” type. 23 of 25 cases of ileal neobladders have been followed up for 2 to 84 months with a mean of 24 months.Results:Operating time ranged from 150 to 310 minutes with a mean of 240 minutes.1 died of cancer metastasis. All patients were satisfactory with the operation except 3 cases. 23 patients achieved excellent daytime continent, while only 14 had nighttime continent. The maximal effective capacity of the neobladder was 200 to 550 ml with a mean of 310 ml.11 patients have taken place inguinal hernia and 1 suffered from incision hernia.3 cases had mild renal dysfunction. 2 patients had hypokalcemia. On IVU examination, failure of imaging of unilateral kidney occurred in 2 patients. 3 cases of patients had unilateral ureter extension or hydronephrosis. 5 cases had their residual urine volume over 50 ml, and 1 case had neobladder stone discovered by BUS. Voiding cystography revealed no ureteral reflux. No patient suffered from neobladder or urethral recurrence.Conclusion:An ileal orthotopic neobladder offers an attractive alternative to a bladder substitute when cystectomy is required.

目的 :观察 7年来行原位回肠代膀胱术的治疗效果。方法 :对 2 5例男性膀胱癌患者行膀胱全切回肠代膀胱术。结果 :2 5例患者中有 2 4例获得随访 ,随访时间 2~ 84个月 ,平均 2 4个月。手术时间平均 2 40 min,输血量平均 5 5 0 m l,手术并发症少 ,2 3例患者白天可控制排尿 ,其中 14例夜间自控排尿。 3例有肾脏或输尿管积水 ,2例肾功能异常。膀胱排尿造影均未发现输尿管反流。血生化检查除 2例发现低血钾外 ,其余血电解质均在正常范围。未发现肠膀胱或尿道肿瘤复发。结论 :原位回肠代膀胱术是值得选择的尿流改道方式。

Objective To evaluate the different methods of continent urinary diversion and the ileal orthotopic neobladder after total cystectomy. Methods 4 different kinds of continent urinary diversion were undertaken after total cystectomy for 68 cases.Continence and catheterization, volume and pressure of the reservoirs, image and hydroelectrolyte condition were investigated. Results Of the 3 cases with intussusceptive efferent tract,2 had partial deintussusception resulting in incontinence and had to...

Objective To evaluate the different methods of continent urinary diversion and the ileal orthotopic neobladder after total cystectomy. Methods 4 different kinds of continent urinary diversion were undertaken after total cystectomy for 68 cases.Continence and catheterization, volume and pressure of the reservoirs, image and hydroelectrolyte condition were investigated. Results Of the 3 cases with intussusceptive efferent tract,2 had partial deintussusception resulting in incontinence and had to be reoperated;44 cases with tapered terminal ileal efferent tract were continent and could be catheterized easily with 16~20F catheters, whereas only one case had difficulty in catheterization. 39 cases with detubularized and reshaped intestinal segment reservoirs, including 3 ileal,22 colonic and 14 ileocolonic, all achieved the demand of low intrareservoir pressure, whereas 8 cases operated in the early period had dilated reservoirs with a volume as large as 1 470~1 650 ml;8 cases with detenia cecocolonic reservoir had the volume of 430~600 ml and as intrareservoir pressure of 30~45 cmH 2O with peristalsis waves,2 of them had urine leakage in the early stage after operation.21 cases with ileal orthotopic neobladder had a volume of 350~480 ml and an intrareservoir pressure of 12~20 cm H 2O.1 being incontinent at daytime and 2 at night whereas all the others were continent. Conclusions Continent urinary reservoirs constructed by 30 cm detubularlized cecocolon can achieve the demand of low intrareservoir pressure.Detenial colonic reservoirs had more chance of urine leakage and adhesion, and higher intrareservoir pressure. Tapered terminal ileal efferent tract is better than ileal intussusception efferent tract for its excellent continence, large caliber, easy catheterization and fewer complications. Ileal orthotopic neobladder has the advantages of excellent continence, higher quality of life, but has limited indications.

目的 评价不同术式可控性膀胱术及回肠新膀胱术的疗效。 方法 对 6 8例膀胱全切除术后患者采用 4种可控性尿流改道及回肠新膀胱术式 ,术后对患者控尿、导 (排 )尿 ,贮尿囊容积、内压 ,影像学及血生化资料进行比较。 结果 回肠套叠式输出道 3例中有 2例部分脱套致术后尿失禁 ,需再次手术 ;缩窄末端回肠式输出道 44例控尿均良好 ,除 1例插管困难外余均能用 16~ 2 0F尿管自行导尿。去管折叠式贮尿囊 39例 ,其中回肠贮尿囊 3例、结肠 2 2例、回结肠 14例 ,能达到低压贮尿囊要求 ,但早期有 8例发生贮尿囊过度扩张 ,容量 1470~ 16 5 0ml;去带结肠贮尿囊 8例 ,容量 430~6 0 0ml,充盈压 30~ 45cmH2 O(1cmH2 O =0 .0 98kPa) ,有蠕动波 ,术后早期有 2例尿漏。回肠新膀胱2 1例 ,容量 35 0~ 46 0ml,充盈压 12~ 2 0cmH2 O ,日间尿失禁 1例 ,夜间尿失禁 2例 ,其余无尿失禁。 结论 盲升结肠 30cm剖开对折成形可控性膀胱可满足低压贮尿囊要求 ,去带结肠贮尿囊由于易发生术后尿漏或粘连 ,内压较高 ,不够理想。缩...

目的 评价不同术式可控性膀胱术及回肠新膀胱术的疗效。 方法 对 6 8例膀胱全切除术后患者采用 4种可控性尿流改道及回肠新膀胱术式 ,术后对患者控尿、导 (排 )尿 ,贮尿囊容积、内压 ,影像学及血生化资料进行比较。 结果 回肠套叠式输出道 3例中有 2例部分脱套致术后尿失禁 ,需再次手术 ;缩窄末端回肠式输出道 44例控尿均良好 ,除 1例插管困难外余均能用 16~ 2 0F尿管自行导尿。去管折叠式贮尿囊 39例 ,其中回肠贮尿囊 3例、结肠 2 2例、回结肠 14例 ,能达到低压贮尿囊要求 ,但早期有 8例发生贮尿囊过度扩张 ,容量 1470~ 16 5 0ml;去带结肠贮尿囊 8例 ,容量 430~6 0 0ml,充盈压 30~ 45cmH2 O(1cmH2 O =0 .0 98kPa) ,有蠕动波 ,术后早期有 2例尿漏。回肠新膀胱2 1例 ,容量 35 0~ 46 0ml,充盈压 12~ 2 0cmH2 O ,日间尿失禁 1例 ,夜间尿失禁 2例 ,其余无尿失禁。 结论 盲升结肠 30cm剖开对折成形可控性膀胱可满足低压贮尿囊要求 ,去带结肠贮尿囊由于易发生术后尿漏或粘连 ,内压较高 ,不够理想。缩窄末段回肠式输出道控尿效果好、内腔大、插管顺利、并发症少 ,明显优于回肠套叠输出道。回肠新膀胱术贮尿排尿功能良好 ,术后生活质量高 ,但应严格选择手术适应证。

Objective] To report the method of laparoscopic radical cystoprostatectomy and ileal orthotopic neobladder. 4 males aged 52 to 65 years with bladder carcinoma underwent surgery from December 2002 to March 2003. Laparoscopic cysto prostatectomy was performed through 5 trocars and reconstruction of neobladder was performed through a small incision. With the technique of Montsouris, the ampullae of vas deferens, seminal vesicles, posterior aspect of prostate were divided, and ureters were dissected outside...

Objective] To report the method of laparoscopic radical cystoprostatectomy and ileal orthotopic neobladder. 4 males aged 52 to 65 years with bladder carcinoma underwent surgery from December 2002 to March 2003. Laparoscopic cysto prostatectomy was performed through 5 trocars and reconstruction of neobladder was performed through a small incision. With the technique of Montsouris, the ampullae of vas deferens, seminal vesicles, posterior aspect of prostate were divided, and ureters were dissected outside the bladder after clips. And then, anterial aspect of bladder and prostate were exposed. The endopelvic fascias and puboprostatic ligaments were separated bilaterally. The vesical and prostatic fibrovascular pedicles were coagulated and separated with harmonic scalpel. The dorsal vein complex was suture ligated and separated. The urethra was transected close to the prostate apex. A 6 cm suprapubic symphysis incision was made to remove the surgical specimens and construction of neobladder was performed. A 50 cm ileal loop was extracted from the abdominal cavity, isolated, detubularized and reconfigured into " M" shape pouch with running suture. The anti reflux ureter implantation was performed by means of inserting the 1 cm of distal ureter into the pouch and fixing with 4 to 6 suture. The urethra neobaldder anastomosis was completed with 6 absorbable sutures. The mean operative time was 8 hours. The mean blood loss was 650 mL. All patients could control urine on day and at night within one month after operation. The capacity of neobladder was about 300 mL. The intravenous urography and retrograde cystography in 3 weeks after operation showed no evidences of ureteric reflux, ureteral obstruction, and well filling neobladder without leakage.[ Conclusion] The procedure combines the advantages of minimally invasive laparoscopy with the speed and safety of open surgery. Ileal neobladder is suitable for construction through a small incision.

【目的】探讨腹腔镜下膀胱前列腺全切除-原位回肠新膀胱手术方法。【方法】为4例52~65岁男性膀胱癌患者施行了手术。采用5个套管针,腹腔镜由脐上或脐下套管针进入,手术者经左侧2个套管针操作,助手经右侧2个套管针操作。游离输精管、精囊,剪开狄氏筋膜分离前列腺后面;游离输尿管下段在其末端切断;剪开前腹壁腹膜反折,游离膀胱前壁;缝扎阴茎背深静脉复合体;游离膀胱侧韧带及前列腺侧韧带;在结扎线近端剪断阴茎背深静脉复合体,紧贴前列腺尖端离断尿道;下腹正中耻骨上作6cm切口,取出切除的膀胱前列腺,将回肠拉出切口外,隔离50cm回肠剖开后“M”形折叠形成贮尿囊,将输尿管末段1cm插入贮尿囊后顶部作吻合,贮尿囊最低位开口与尿道断端6针吻合。【结果】手术时间平均约为8h,出血量平均为650mL。术后3周作腹部平片、静脉尿路造影,以及新膀胱造影检查,显示:新膀胱充盈良好,容量约300mL,无输尿管返流及梗阻,所有患者术后1个月内恢复控尿功能。无排尿困难及残余尿。【结论】腹腔镜下切除膀胱前列腺视野清楚,可减少出血,避免尿道括约肌损伤,保留神经血管束;可减少肠管暴露时间,有利用术后肠道功能恢复,减少肠粘连。作一小切口取出膀胱前列腺,并将...

【目的】探讨腹腔镜下膀胱前列腺全切除-原位回肠新膀胱手术方法。【方法】为4例52~65岁男性膀胱癌患者施行了手术。采用5个套管针,腹腔镜由脐上或脐下套管针进入,手术者经左侧2个套管针操作,助手经右侧2个套管针操作。游离输精管、精囊,剪开狄氏筋膜分离前列腺后面;游离输尿管下段在其末端切断;剪开前腹壁腹膜反折,游离膀胱前壁;缝扎阴茎背深静脉复合体;游离膀胱侧韧带及前列腺侧韧带;在结扎线近端剪断阴茎背深静脉复合体,紧贴前列腺尖端离断尿道;下腹正中耻骨上作6cm切口,取出切除的膀胱前列腺,将回肠拉出切口外,隔离50cm回肠剖开后“M”形折叠形成贮尿囊,将输尿管末段1cm插入贮尿囊后顶部作吻合,贮尿囊最低位开口与尿道断端6针吻合。【结果】手术时间平均约为8h,出血量平均为650mL。术后3周作腹部平片、静脉尿路造影,以及新膀胱造影检查,显示:新膀胱充盈良好,容量约300mL,无输尿管返流及梗阻,所有患者术后1个月内恢复控尿功能。无排尿困难及残余尿。【结论】腹腔镜下切除膀胱前列腺视野清楚,可减少出血,避免尿道括约肌损伤,保留神经血管束;可减少肠管暴露时间,有利用术后肠道功能恢复,减少肠粘连。作一小切口取出膀胱前列腺,并将肠管拉出体外形成贮尿囊,可大大缩减手术时间。回肠作贮尿囊有取材容易

 
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