RÉSUMÉ
Objective To investigate the clinical therapeutic effect of sigmoid neobladder after laparoscopic radical cystectomy in the treatment of invasive bladder cancer .Methods 21 patients with invasive bladder cancer accepted sigmoid neobladder after laparoscopic radical cystectomy and pelvic lymphadenectomy .The postoperative complications and clinical therapeutic effect were analyzed .Results All surgeries were completed successfully .The operation time was (245 ±125) min,blood lost was (98 ±45) mL.All the 21 patients were followed up for 3-24 months,mean of 12 months.Both side mild hydronephrosis in 6 cases (28.6%) and unilateral hydronephrosis in 1 case(0.5%).Average bladder reservoir was (548.8 ±221.6)mL,the maximum bladder pressure during the new bladder urine storage period was (2.26 ±0.24) kPa,the maximum bladder pressure during voiding period was (6.18 ±0.29) kPa,volume of residual urine was (87 ±52) mL.The mean maximum uroflow rate was (83.2 ± 5.6)mL/s.The continence of micturition was 90.4% in day-time and 76.1% in night-time.1 case had urethral stricture and got better after the urethral dilatation .Conclusion The sigmoid neobladder after laparoscopic radical cystectomy has more reliable results,without serious postoperative complications and patients with high quality of life after operation.This operation may be applied in clinical practice .
RÉSUMÉ
Objective:To investigate the clinlic therapeutic effect of sigmoid orthotopic neobladder after radical cystectomy in the treatment of invasive bladder cancer.Methods:1 6 patients with invasive bladder cancer (all males;age range from 53 to 75 years)were admitted and underwent radical cystectomy and sigmoid orthotopic neobladder.Results:Sixteen patients were hospitalized for 37 to 62 d,with an average of 51 d.All patients were followed up for a mean of 26 months (range from 5 months to 6 years).The serum creatinine (Cr)and blood urea nitrogen (BUN)levels were both in the normal range and there was no acidosis in all the cases. No case had unilateral ureteral urine reflux during cystography. Of the 16 patients 14 cases (87.5%) achieved continence during daytime;6 cases (37.5%) were incontinent at night, but all of them could control urination by being woken up at night.The capacity of the neobladder was 245 to 380 mL with an average of 316 mL and the maximal pressure of the neobladder during filling was 28 to 57 cm H2 O (1 cm H2 O =0.098 kPa)with an average of 39 cm H2 O.Conclusion:As an operation the sigmoid orthotopic neobladder can be performed easily without serious postoperative complications and has more reliable results. This operation may be generally applied in clinical practice.