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目的探讨根治性膀胱全切输尿管单乳头皮肤造口治疗晚期膀胱癌的手术适应证及治疗效果。方法采用单乳头输尿管一侧腹壁造口术式,即将左侧输尿管经乙状结肠腹膜后转移至右侧与该侧输尿管一并引出腹壁,形成单乳头,外接集尿袋。治疗11例浸润性膀胱癌。结果乳头形成好,术后尿液引流通畅,无手术死亡及严重并发症。随访2个月～1.5年无乳头回缩塌陷、肾盂肾炎。经大剂量静脉肾盂造影、B超检查,证实双肾无明显积水。结论该手术操作简单、安全、并发症少、成功率高,特别适合输尿管扩张积水的老年、全身情况差,不宜行复杂手术的高危患者。
Objective To investigate the surgical indications and therapeutic effects of radical cystectomy of the ureter with single nipple skin stoma for the treatment of advanced bladder cancer. Methods One-sided single-head ureter with an abdominal wall ostomy was used. The left ureter was transabdominally transferred to the right side of the sigmoid colon and led to the abdominal wall together with the ureter to form a single nipple and an external urine collection bag. Treatment of 11 cases of invasive bladder cancer. Results nipple formation, postoperative urinary drainage patency, no operative death and serious complications. Follow-up 2 months ~ 1.5 years without nipple retraction collapse, pyelonephritis. The bolus intravenous pyelography, B-ultrasound, confirmed no significant hydronephrosis. Conclusion The operation is simple and safe, with fewer complications and high success rate. It is especially suitable for elderly patients with ureteral dilatation and stagnancy, poor general condition, and complicated with complicated surgery.