目的 评价根治性膀胱切除原位新膀胱手术采取乙状结肠或回肠重建膀胱对患者术后恢复的影响.方法 回顾性分析2002年12月～2012年12月84例膀胱癌患者,分析行膀胱根治术+原位新膀胱手术采取乙状结肠或回肠重建膀胱患者的一般资料和术后情况,比较两者间术后并发症发生、控尿恢复时间以及术后住院时间差异性.结果 84例病例中70例接受了原位新膀胱术,58例患者采取回肠原位新膀胱术,年龄48～89岁,术后并发症发生率为29.3％ (17/58),术后21 d恢复控尿为91.4％,术后至出院时间为23.5 d;12例患者采取结肠原位新膀胱术,年龄28～80岁,术后并发症发生率为58.3％ (7/12),术后21 d恢复控尿为66.7％,术后至出院时间为25 d.新膀胱取不同肠道重建与术后并发症、控尿恢复时间、术后恢复出院时间均有统计学意义(P＜0.05).结论 根治性膀胱切除原位新膀胱手术采取回肠重建新膀胱较采用结肠更有利于患者的术后恢复.%Objective To compare the postoperative recovery among patients undergoing orthotopic bladder substitution with sigmoid or ileal grafts.Methods The clinical data and postoperative recovery (postoperative complications,continence recovery time and postoperative hospital stay) of 84 patients receiving orthotopic bladder substitution with sigmoid or ileal grafts after radical cystectomy for bladder cancer were analyzed.Results Of the 84 cases,70 had continent urinary reservoirs constructed,among whom 58 (aged 48-89 years) received an ileal neobladder (IN) and 12 (aged 28-80 years) received a sigmoid neobladder (SN).The postoperative complications rate,continence recovery time and postoperative hospital stay in IN group was 29.3％ (17/58),91.4％,and 23.5 days,as compared to 58.3％(7/12) (P=0.04),66.7％ (P=0.03),and 25 days (P=0.04) in patients in SN group,respectively.Conclusion A neobladder constructed from ileal grafts achieves better postoperative recovery results compared to a neobladder constructed from sigmoid grafts.
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