腹腔镜下改良回肠-新膀胱瘘修补术的疗效分析

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Efficacy of modified laparoscopic repair of ileal-neobladder fistula

HOU Yidong，ZHAO Liang，WANG Jinyou，MIN Jie，WANG Yi，ZHANG Tao，YU Dexin （Department of Urology，The Second Afiliated Hospital of Anhui Medical University，Hefei 23060l，China）

ABSTRACT：ObjectiveToevaluate the feasibilityandtechnicaladvantages of modifiedlaparoscopicileal-neobladder fistula repair.MethodsAretrospectiveanalysis wasconducted on the clinical dataof 4patients who underwent radical cystectomy + orthotopic neobladdersurgeryandsubsequentlydevelopedileal-neobladderfistula and received modified repairsurgery in our hospital during Jan.2O19andDec.023.Underlaparoscopy，theileumatboth endsof the fistulawas transected，andanend-to end ileal anastomosis bypass was established.ResultsAll4 patients successfullycompleted theoperation.Theirage was 6，50， 76and 59yearsrespectively.eal-neobbladderfistulaoccrrd4，1，2and16monthsafteradicalresection.Theoperationtime was l29，98，105 and 90 minutes.The intraoperative blood loss was 50，60，70 and 50mL .The postoperative exhaust time was 3， 4，3and5days.Thepostoperative hospital staywas8，7，7and9days，andthepostoperativedrainage tube indweling time was 5，4，5and7days.Noobvious complications occured afteroperation.During folow-upof1 to6years，nonerecurrence orlongtermstenosis of the intestinal anastomosis occurrd.The symptoms of urinary tract infection improved significantly，nd the bladder functionremained stable.ConclusionThe modified laparoscopic repair of ileal-neoblader fistulaachieves minimally invasiverepair byavoiding extensiveadhesionseparation.Ithas theadvantagesofsafeoperationrapidrecovery，and few complications，and is a safe option for the treatment of ileal-neobladder fistula.

KEY WORDS： bladder cancer； orthotopic neobladder； ileal-neobladder fistula；radical cystectomy

摘要：目的回肠-新膀胱瘘是根治性膀胱切除术后罕见但严重的并发症，传统修补术存在操作复杂、并发症发生率高等问题。（剩余7420字）