Analysis Of The Clinical Application To The Treatment Of Bladder Malignant Tumor By Modified Sigma Rectun Pouch

Objectives: A retrospective analysis of preperative,intraoperative,postoperative and follow-up date of these patients who accepted modified Sigma Ureterosigmoidostomy from november.2006 to november.2013. To analysis feasibility, safety and effectiveness on this urinary diersion in our hospital.Methods: Finding bladder neoplasm patients who accepted modified Sigma rectun pouch from november.2006 to november.2013 in department of urology according electronic-center network medical-record and medical record library of our hospital. And finding relevant date of X-ray and CT at department of radiology. Collecting preperative, intraoperative, postoperative, follow-up date and general information of these patients and make a follow-up schedule. To discuss feasibility, safety and effectiveness on this urinary diersion in our hospital through collecting, sorting,statistics and analysis these clinical date.Results: A total of 23 patients completed the study,19 males and 4 females, The mean age of patients was 64.5 years and the male-to-female ratio was 4.75:1. The first time of bladder neoplasm were 19 patients and 4 patients after trasnurethral resection of bladder tumor. Mean total operation time 295min(240~360min),mean modified Sigma operation time 80min(65~100min). The pathological confirmed after operation:single tumor were 6 patients and 17 patients of multiple tumor,the bigest tumor 13.0*9.5*3.3cm,all of them were transitional cell cancer,tranfer to prostate 2 patients and to lynph node was one pantient.The mean time of pulling out of the anal canal and double J canal was 12 days(9~16days).The mean hospitalization days of after operation were 28 days(15~51days).The urine as normal as usual after 3 months.The daytime urination were 6 times(4~10times) and 2 times through night.The urination volume were 100~450 ml every time.One person was retrograde infection after 3 months of operation,the patient was well after anti-infection drugs. One patient was founded much water at the right side of renal pelvis,percutaneous renal anterograde ureteral balloon expansion,there was no water in renal pelvis after one year.One patient sudden death unexplained after 14 months of operation,postoperative pathologic:T4N0M0.The tumor recurrence after 23 months in one case and death two months later,postoperative pathologic:T3N2M0,lymph nodes(10/11).One case who irregular took alkaline drugs was mild metabolic acidosis after 3 months,cured by small doses of sodium bicarbonate.The quality of life(QOL) of patients was 41 points(29~51 points) after half a year.Conclusions: Modified Sigma rectun pouch is a Urinary diversion operation which can be control, without abdominal skin surface colostomy and intubation catheter on a regular basis.There are less cost long-term.Patients were able to adapt hole anal urination.they were satisfaction to urination control and quality of life.There were less postoperative complication such as diarrhea,retrograde infection and acid-base balance diserders,easy to control if treatment actively.