| Objective:The output, was constricted and suspened, which enhanced the regulatory that the bladder was replaced of ileum. In the paper, the bladder cancer was treated with this surgery. In order to evaluate its safety and efficacy and explore the clinical application value.Methods:From July 2001 to August 2009,32 patients (Group I) with bladder cancer accepted enhancement controllable output channel narrowed ileal bladder suspension surgery and total cystectomy; and 36 patients (Group II) were given ileal neobladder. The two groups of patients with perioperative, postoperative complications and tumor progress were comparative analyzed, such as:statistical intraoperative blood loss, operative time, hospitalization time, observe the early and late complications, such as the bladder leakage, infection of incision, electrolyte disorder, intestinal obstruction, storage allantoic stones, urethra tumor recurrence, and so on. After surgery, postoperative every 3 months and every 6 months(one year later), routine blood and urine biochemical, urinary tract, pelvic cavity and retroperitoneal B to exceed were regularly reviewed, and the CT was also reviewed when it is necessary. Observe whether there is a transfer of tumor recurrence, kidney seeper, allantoic calculi complications such as lay aside. Relevant data using SPSS 17.0 software for statistical analysis, comparison between count data set by chi-square test, measurement data to x±s said, between group is compared by t-test, inspection level α=0.05.Results:Group I:average time of operation is 5.8±2.2 h, the volume of intraoperative bleeding is 489.8±115.6 ml, no perioperative deaths. Postoperative urinary continence good output, can be self clean urethral catheterization, postoperative hospitalization time is 21.4±7.1 days. Group Ⅱ:average time of operation is 5.0±1.7 h, compared with group I (P<0.05), intraoperative blood loss (477.2±113.1) ml, compared with group I (P> 0.05), postoperative hospitalization 17.7±7.6 days, compared with group I (t=2.059, P=0.043). Enhanced controllable output channel narrowing ileal bladder suspension surgery, which operative time and postoperative hospital stay are longer than ileal neobladder group. In addition, they are significant difference. Recent postoperative complications such as urinary fistula, abdominal incision infection, stress ulcer, pulmonary infection, electrolyte balance disorder, is not complete ileus comparison. There was no statistically significant difference between the two groups, such as the recent complications after treatment for symptomatic support to heal. Followed up for 2～5 years, two groups respectively for the clinical curative effect satisfaction are group I 27 (81.3%) cases, group II 29 (83.3%) cases. Compared two groups (chi-square=0.170, P=0.680), there are no statistical difference. Group I postoperative 3 months to urethral catheterization difficult 1 (3.1%) cases, to lien F16 urine tube for 10 days, guiding catheter method can be well on their own after urethral catheterization. Patients with postoperative urethral catheterization number itself for 5～6 times during the day and night 1～2 times. Six months later, capacity of the ileum bladder is 300～600 ml.1 years later, ileal bladder pressure filling state average 22.4 cm H2O (18.4～26.5 cm H2O). In regard to the blood loss, postoperative hospital stay, and postoperative far or recent complications, both surgical methods were no significant statistical difference. The group of Enhanced controllable output channel narrowing ileal bladder suspension surgery can be very good control of urination and drain on its own after operation.Conclusions:Enhanced controllable output channel narrowing ileal bladder suspension surgery is controllable urinary diersion better operation, good safety and clinical curative effect, worth clinical application. This is especially suitable for the patients who need control inurine and don’t accepted Orthotopic neobladder. |
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