Application Of Ureteral Mesenteric Subserosal Tunnel Posterior Wall Anastomosis In Sigmoid Colon In Situ New Bladder

Objective(s):To investigate the application of ureteral submucosal tunnel posterior wall anastomosis in the sigmoid neoplasia of the sigmoid colon,and to compare the sigmoid colon neobladder with the anastomosis and the sigmoid colon orthoplasty with direct anastomosis by efficacy and postoperative complications.Methods:This study retrospectively analyzed the clinical outcomes of 68 patients with bladder malignancies who underwent radical cystectomy and orthotopic neobladder surgery in the Department of Urology,Second Affiliated Hospital of Kunming Medical University from January 2015 to January 2018.Treatment,3 patients were excluded from the follow-up,these cases were grouped.Among them,35 patients were divided into group A by using ureteral mesenteric tunneling posterior wall anastomosis?and 30 patients were treated with direct anastomosis.Divided into group B,comparative analysis of the blood loss during operation,operation time.postoperative hospital stay,extubation time,postoperative complications such as hydronephrosis,intestinal obstruction and other related early and long-term Relevant data such as important complications,data processing were completed by SPSS 20.0 statistical software,measurement data were analyzed by variance,and t-test was used for comparison between groups.The data were expressed by mean plus standard deviation,and qualitative data were expressed by rate(%).Chi-square test was used for comparison between groups.Results:Of the 68 patients in this study,65 patients were followed up.and the follow-up rate was 95.6%.One patient who underwent ureteral mesenteric tunneling posterior wall anastomosis was lost to follow-up,and 2 patients who did not use the surgical procedure had 2 patients.After loss of follow-up,after excluding these 3 patients who were lost to follow-up,the follow-up time was 12-36 months,.The patients were all operated smoothly,and the postoperative recovery was good.All of them recovered and were discharged.There were no significant differences in gender,age and clinical stage between the two groups.There was no significant difference between group A and group B in terms of operation time,intraoperative blood loss and blood transfusion.Groups A and B were There were no significant differences in postoperative hospital stay,Postoperative ureteral stent indwelling time,and catheter indwelling time.By comparing the postoperative complications in group A and group B,the probability of postoperative intestinal obstruction in group A was lower than that in group B(P<0.05).At the same time,through postoperative follow-up,the probability of hydronephrosis in group A was lower than that in group B,and the difference was statistically significant(p<0.05).Conclusion(s):Radical bladder full-surgery sigmoid colon orthotopic neobladder is a better method for urinary diversion after total bladder in patients with bladder malignant tumor.Especially for patients with better self-conditions and fewer underlying diseases,higher quality of life after surgery,and longer life expectancy,radical cystic sigmoid in situ neobladder can achieve good results;In the sigmoid colon orthotopic neobladder,the ureteral mesenteric subserosal tunnel posterior wall anastomosis method is easier than the direct anastomosis method,which makes the patient easier to review after surgery,and can reduce the incidence of postoperative intestinal obstruction,and can avoid the bladder.Urine reflux,thereby protecting the upper urinary tract function.