完全腹腔镜下膀胱根治性切除-原位回肠新膀胱术中经尿管逆行置入双J管的应用效果

Application effect of retrograde insertion of double J stent through urinary catheter in totally laparoscopic radical cystectomy and orthotopic ileal neobladder

摘要:

目的 探讨完全腹腔镜下膀胱根治性切除-原位回肠新膀胱术中经尿管逆行置入双J管的应用效果。方法 回顾性分析2020年9月－2021年10月该院5例行完全腹腔镜下膀胱根治性切除-原位回肠新膀胱术，并于术中经尿管逆行置入双J管患者的临床资料。结果 5例患者在完全腹腔镜下行全膀胱全切，采用经尿管逆行放置双J管，在术后均未出现严重并发症。新膀胱术中置入双J管，操作时间2～4 min，单侧平均置入时间为（2.8±0.6）min，住院时间为（13.0±0.8）d。5例患者术后排尿恢复较好，且在病情恢复过程中均未发生尿漏和感染。结论 在完全腹腔镜下膀胱根治性切除-原位回肠新膀胱术中，应用经尿管逆行置入双J管的方法，取得了良好的应用效果，可以在不破坏气腹的同时缩短手术时间，有利于患者术后排尿功能的恢复，其是一种在新膀胱术中安全、有效且便捷的辅助手段。

Abstract:

Objective To explore the application of retrograde placement of double J stent through urinary catheter in totally laparoscopic radical cystectomy and orthotopic ileal neobladder.Methods Retrospectively analyzed the data of 5 patients who underwent retrograde placement of double J stent through urinary catheter in totally laparoscopic radical cystectomy and orthotopic ileal neobladder from September 2020 to October 2021.Results All the 5 patients underwent retrograde placement of double J stent through urinary catheter in totally laparoscopic radical cystectomy and orthotopic ileal neobladder, and no major complications occurred. Double J stent was placed in the neobladder with the above method, operative time was 2 ~ 4 min, with an average of (2.8 ± 0.6) min, and the average hospital stay was (13.0 ± 0.8) d. At present, the recovery of urination in 5 patients was good, and no urinary leakage and infection occurred during the recovery process.Conclusion Retrograde placement of double J stent has been successfully used in orthotopic ileal neobladder with totally laparoscopic radical cystectomy. It can shorten the operation time without destroying pneumoperitoneum, and is conducive to the recovery of urinary function of patients after operation. It is a safe, effective and convenient auxiliary method in neobladder operation.