| Objective: To explore the management and prevention of postoperative complications of orthotopic neobladder surgery,with emphasis on improving urinary control and monitoring of neobladder volume.Methods: A retrospective investigation was conducted from January 2006 to May 2018.46 patients were successfully followed up after orthotopic cystectomy for bladder cancer in our hospital,and their general conditions,clinical manifestations,preoperative diagnosis,surgical methods and postoperative complications were discussed in combination with relevant literature.Results: Early and long-term complications were divided into three months after the operation.Early complications occurred in 6 cases of orthotopic neobladder surgery,including fever in 1 case,intestinal obstruction in 2 cases,neovesical vaginal fistula in 1 case,intestinal fistula in 1 case,and mild hydronephrosis in 1 case.And long-term complications occurred in 35 patients,including 1 case of asymptomatic bacteriuria with bladder stones;bilateral ureteral neobladder anastomotic stenosis in 1 case;1 case of stress incontinence;There were 4 cases of nocturnal incomplete incontinence and 22 cases of nocturnal enuresis with 1 case double kidney stones;Tumor recurrence in 2 cases;There were 4 deaths.Conclusion: There are many complications after orthotopic neobladder surgery,but most of them are relatively easy to deal with,without increasing surgical trauma,affecting the effect of radical resection of tumor and avoiding abdominal ostomy.However,the incidence of postoperative incontinence complications is the highest,so further improvement of urinary control has become the most concerned topic between doctors and patients.Regular monitoring of urinary control,as far as possible to make the new bladder to normal bladder micturition,improve the quality of life of patients. |
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