輸尿管皮膚造口術(shù)-皮瓣嵌入法用于根治性膀胱切除術(shù)+尿流改道術(shù)10例效果初探

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Efficacy of cutaneous ureterostomy-flap embedding in radical cystectomy plus urinary diversion in 10 cases

YU Xufeng，HUA Meimian，ZENG Shuxiong，CHEN Qing，WANG Ziwei，YING Yidie，WANG Maoyu，ZHANG Chen，WANG Yi，XU Chuanliang

（Department of Urology，Shanghai Changhai Hospital，Shanghai 200433，China）

ABSTRACT：Objective To explore the clinical application of cutaneous ureterostomy-flap embedding in radical cystectomy plus urinary diversion.Methods The clinical data of 10 patients with bladder cancer treated with this method in our hospital during Feb.and May 2023 were involved.Cutaneous ureterostomy-flap embedding was used in urinary diversion.The stoma-free rate and stenosis rate of stomas within 1 year postoperatively，differences in renal function indicators 1 day before operation and 1 year after operation，urinary diversion-related complications within 6 months postoperatively，including hydronephrosis，urinary tract infections，renal stones were analyzed.Results All surgeries were successfully completed.At 1 year postoperatively，renal function indicators showed no significant difference compared to preoperative levels （P>0.05）.At 6 months postoperatively，1 patient developed renal stones，successfully treated with surgery; 2 had urinary tract infection，recovered after antibiotic treatment; 2 had mild unilateral hydronephrosis，alleviated with conservative management.At 1 year postoperatively，the catheter-free rate was 80%（8/10），with no worsening of hydronephrosis or occurrence of ureteral obstruction，and the stent placement duration ranged from 97 to 211 days，average （151.63±42.47） days.The ureteral stent was not removed in 2 patients within 1 year，so the stoma stenosis rate was 20%（2/10）.Conclusion The application of flap embedding in urinary diversion following radical cystectomy is a simple and safe procedure，with few postoperative complications，high success rate of stent removal，and overall favorable outcomes.

KEY WORDS：bladder cancer; urinary diversion; cutaneous ureterostomy; modified surgery；flap embedding

摘要：目的 探討輸尿管皮膚造口術(shù)-皮瓣嵌入法在根治性膀胱切除術(shù)+尿流改道術(shù)中的臨床應(yīng)用效果。（剩余10117字）