【摘要翻译】盲肠膀胱成形术治疗难治性间质性膀胱炎：长期的结果
发布于 2004-06-12 · 浏览 443 · IP 陕西陕西
这个帖子发布于 20 年零 331 天前，其中的信息可能已发生改变或有所发展。
[文题]Caecocystoplasty for Intractable Interstitial Cystitis: Long-Term Results
盲肠膀胱成形术治疗难治性间质性膀胱炎：长期的结果
[来源]European Urology
[年、卷、期、页]2004. 46(1): Pages 114-117
[作者]Aniruddha Chakravarti, , Suresh Ganta, Bhaskar Somani and Malcolm Anthony Jones
[原文摘要]
Objective: To evaluate the role of orthotopic substitution caecocystoplasty in intractable interstitial cystitis refractory to conservative measures by looking at long-term follow-up results.
Patients and Methods: We present a retrospective review of eleven patients who underwent a trigone-preserving orthotopic substitution caecocystoplasty for intractable classical interstitial cystitis. All patients received conservative treatment for a mean period of three years. They were followed up for a mean period of nine years (range 4–14 years) with evaluation of symptoms, biochemistry, ultrasound scan and flexible cystoscopy.
Results: Symptomatic relief was universal with an increase of bladder capacity to normal. There was no mortality and the postoperative morbidity was minimal. Intermittent self-catheterisation due to high residual volumes was necessary in two patients. There was no significant urinary reflux or metabolic complications noted. Two patients required a cystectomy after four and six years respectively due to recurrent trigonal disease in one and urethro-trigonal hypersensitivity following intermittent self-catheterisation in the other patient. One patient developed an advanced adenocarcinoma in the caecal segment seven years following the primary operation.
Conclusion: A sustained relief of symptoms is noted after trigone-preserving orthotopic substitution caecocystoplasty in intractable classical interstitial cystitis. It may not be appropriate in patients with urethro-trigonal disease or hypersensitivity. There is low long-term morbidity due to the operation but is associated with malignancy in the augmentate. Long-term follow-up is necessary to identify malignant change in the bladder.
[中文译文]
目的：长期随访以评估原位替代的盲肠膀胱成形术对保守措施无效的难治性间质性膀胱炎的作用。
病例和方法：回顾11例因难治的典型间质性膀胱炎接受保留三角区的原位替代的盲肠膀胱成形术的患者。患者接受保守治疗平均3年，术后随访平均9年（4-14年），随访内容包括症状、生化、超声和可弯的膀胱镜检查。
结果：普遍症状得以消除，以及膀胱容量增加至正常。无死亡者，术后并发症很少。2例患者因残余尿量多而行间歇自家导尿。无明显尿液返流和代谢并发症。2例患者分别于术后4年和6年需要膀胱切除，一例因复发的三角区疾病，一例因间歇自家导尿后的尿道-三角区高敏感。一例患者于手术后7年在盲肠段发生晚期腺癌。
结论：在因难治的典型间质性膀胱炎接受保留三角区的原位替代的盲肠膀胱成形术患者可以观察到持续的症状缓解。在尿道-三角区疾病或高敏感的患者此法可能不适用。因长期并发症因手术所致较少，但与扩大膀胱的恶性肿瘤有关。有必要长期随访以观察膀胱的恶变。
[个人评论]不知道此法和环孢素治疗孰优？
盲肠膀胱成形术治疗难治性间质性膀胱炎：长期的结果
[来源]European Urology
[年、卷、期、页]2004. 46(1): Pages 114-117
[作者]Aniruddha Chakravarti, , Suresh Ganta, Bhaskar Somani and Malcolm Anthony Jones
[原文摘要]
Objective: To evaluate the role of orthotopic substitution caecocystoplasty in intractable interstitial cystitis refractory to conservative measures by looking at long-term follow-up results.
Patients and Methods: We present a retrospective review of eleven patients who underwent a trigone-preserving orthotopic substitution caecocystoplasty for intractable classical interstitial cystitis. All patients received conservative treatment for a mean period of three years. They were followed up for a mean period of nine years (range 4–14 years) with evaluation of symptoms, biochemistry, ultrasound scan and flexible cystoscopy.
Results: Symptomatic relief was universal with an increase of bladder capacity to normal. There was no mortality and the postoperative morbidity was minimal. Intermittent self-catheterisation due to high residual volumes was necessary in two patients. There was no significant urinary reflux or metabolic complications noted. Two patients required a cystectomy after four and six years respectively due to recurrent trigonal disease in one and urethro-trigonal hypersensitivity following intermittent self-catheterisation in the other patient. One patient developed an advanced adenocarcinoma in the caecal segment seven years following the primary operation.
Conclusion: A sustained relief of symptoms is noted after trigone-preserving orthotopic substitution caecocystoplasty in intractable classical interstitial cystitis. It may not be appropriate in patients with urethro-trigonal disease or hypersensitivity. There is low long-term morbidity due to the operation but is associated with malignancy in the augmentate. Long-term follow-up is necessary to identify malignant change in the bladder.
[中文译文]
目的：长期随访以评估原位替代的盲肠膀胱成形术对保守措施无效的难治性间质性膀胱炎的作用。
病例和方法：回顾11例因难治的典型间质性膀胱炎接受保留三角区的原位替代的盲肠膀胱成形术的患者。患者接受保守治疗平均3年，术后随访平均9年（4-14年），随访内容包括症状、生化、超声和可弯的膀胱镜检查。
结果：普遍症状得以消除，以及膀胱容量增加至正常。无死亡者，术后并发症很少。2例患者因残余尿量多而行间歇自家导尿。无明显尿液返流和代谢并发症。2例患者分别于术后4年和6年需要膀胱切除，一例因复发的三角区疾病，一例因间歇自家导尿后的尿道-三角区高敏感。一例患者于手术后7年在盲肠段发生晚期腺癌。
结论：在因难治的典型间质性膀胱炎接受保留三角区的原位替代的盲肠膀胱成形术患者可以观察到持续的症状缓解。在尿道-三角区疾病或高敏感的患者此法可能不适用。因长期并发症因手术所致较少，但与扩大膀胱的恶性肿瘤有关。有必要长期随访以观察膀胱的恶变。
[个人评论]不知道此法和环孢素治疗孰优？
最后编辑于 2004-06-20 · 浏览 443
回复收藏点赞
