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題名 | Orthotopic Bladder Substitution in Women Using the Ileal Neobladder=以迴腸代用膀胱於女性病人作原位性膀胱置換 |
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作者姓名(中文) | 江博暉; 黃裕勝; 吳文正; 江金培; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 99:4 2000.04[民89.04] |
頁次 | 頁348-351 |
分類號 | 416.274 |
關鍵詞 | 迴腸; 膀胱; 原位性膀胱置換; 女性病人; Bladder; Cystectomy; Neobladder; Orthotopic urinary diversion; Urethrectomy; |
語文 | 英文(English) |
英文摘要 | Before 1990, orthotopic bladder substitution was limited to men and urethrectomy was routinely performed in women—making orthotopic reconstruction impossible. Following studies on pelvic exenteration for transitional cell bladder cancer patients, and after anatomic studies of the female urethra, the first report on orthotopic bladder substitution was published in 1994. Here, we present our ileal neobladder technique, which was applied for the treatment of bladder cancer in three women, and sigmoid colon cancer with vesical metastasis in one woman. This surgical procedure preserves the urethral sphincter, the endopelvic fascia, and the pubourethral ligaments. The innervation of the sphincter is also maintained. A 45-cm segment is isolated from the distal ileum and arranged in a W-shaped configuration. An anastomosis between the ileal bladder and the urethra is made and an antireflux ureteroileal implantation is created. Postoperatively, all patients reported daytime continence. The average urinary flow rate was 13.5 �b�n2.1 mL/sec 3 months after surgery. The reservoir had low pressure and high capacity. There was no reflux or deterioration of renal function. In properly selected female patients undergoing radical cystectomy, an ileal neobladder is now an option. |
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