Abstract：
OBJECTIVE: To assess the viability of this procedure in laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction, the objective of this study is to examine the relationship between urinary flow parameters of urethral drag-and-bond anastomosis in the reconstruction of the ileal orthotopic neobladder.
METHODS: 36 patients with bladder cancer underwent laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction at Jiangxi provincial people\'s hospital between June 2016 and January 2021,16 patients underwent intermittent urethral anastomosis, while 20 patients underwent neobladder-urethral drag-and-bond anastomosis. The maximum bladder capacity, residual urine output, maximum urinary flow rate, and outlet morphology of the new bladder neck were all monitored throughout postoperative follow-up regularly.
RESULTS: There was no significant difference between the urethral drag-and-bond anastomosis group (group A) and the conventional anastomosis group (group B) at 3 months and 12 months after surgery, and the maximum bladder capacity (3 months, 488.35 ± 51.56 ml vs 481.06 ± 40.61 ml, t = -0.462, P = 0.647; 12 months, 496.35 ± 51.09 ml vs 476.56 ± 56.33 ml, t = -1.103, P = 0.278), residual urine output (3 months, 44.15 ± 24.12 ml vs 38.69 ± 21.82 ml, t = -0.704, P = 0.486;12 months, 49.65 ± 26.95 ml vs 36.75 ± 21.96 ml, t = -1.546, P = 0.131) and maximum urine flow rate (3 months, 12.36 ± 2.63 ml/s vs 13.60 ± 2.82 ml/s, t = 1.361, P = 0.182;12 months, 12.18 ± 3.14 ml/s vs 11.13 ± 3.01 ml/s, t = -1.004, P = 0.322) of the two groups were not significant (P > 0.05). The new bladder outlet morphology was not distorted in group A patients, the continuity was good, and there were fewer associated complications.
CONCLUSIONS: There was no significant difference in postoperative urodynamic parameters between the urethral drag-and-bond anastomosis group and the conventional anastomosis group, and the postoperative new bladder outlet was in good shape, with clinical significance.
METHODS: 36 patients with bladder cancer underwent laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction at Jiangxi provincial people\'s hospital between June 2016 and January 2021,16 patients underwent intermittent urethral anastomosis, while 20 patients underwent neobladder-urethral drag-and-bond anastomosis. The maximum bladder capacity, residual urine output, maximum urinary flow rate, and outlet morphology of the new bladder neck were all monitored throughout postoperative follow-up regularly.
RESULTS: There was no significant difference between the urethral drag-and-bond anastomosis group (group A) and the conventional anastomosis group (group B) at 3 months and 12 months after surgery, and the maximum bladder capacity (3 months, 488.35 ± 51.56 ml vs 481.06 ± 40.61 ml, t = -0.462, P = 0.647; 12 months, 496.35 ± 51.09 ml vs 476.56 ± 56.33 ml, t = -1.103, P = 0.278), residual urine output (3 months, 44.15 ± 24.12 ml vs 38.69 ± 21.82 ml, t = -0.704, P = 0.486;12 months, 49.65 ± 26.95 ml vs 36.75 ± 21.96 ml, t = -1.546, P = 0.131) and maximum urine flow rate (3 months, 12.36 ± 2.63 ml/s vs 13.60 ± 2.82 ml/s, t = 1.361, P = 0.182;12 months, 12.18 ± 3.14 ml/s vs 11.13 ± 3.01 ml/s, t = -1.004, P = 0.322) of the two groups were not significant (P > 0.05). The new bladder outlet morphology was not distorted in group A patients, the continuity was good, and there were fewer associated complications.
CONCLUSIONS: There was no significant difference in postoperative urodynamic parameters between the urethral drag-and-bond anastomosis group and the conventional anastomosis group, and the postoperative new bladder outlet was in good shape, with clinical significance.
摘要：
目的：评估腹腔镜下根治性膀胱切除术合并回肠原位新膀胱重建术的可行性，这项研究的目的是研究尿道拖拽和粘合吻合术在回肠原位新膀胱重建中的尿流参数之间的关系。
方法：江西省人民医院2016年6月至2021年1月对36例膀胱癌患者行腹腔镜膀胱根治性切除加回肠原位新膀胱重建术，其中16例患者行间歇性尿道吻合术。而20例患者接受了新膀胱-尿道拖曳和粘合吻合术。最大膀胱容量，残余尿量,最大尿流率,新膀胱颈的出口形态均在术后随访期间定期监测。
结果:术后3个月和12个月尿道拖合吻合术组(A组)与常规吻合术组(B组)无显著性差异,和最大膀胱容量（3个月，488.35±51.56mlvs481.06±40.61ml，t=-0.462,P=0.647;12个月,496.35±51.09mlvs476.56±56.33ml，t=-1.103,P=0.278),残余尿量（3个月，44.15±24.12mlvs38.69±21.82ml，t=-0.704,P=0.486;12个月,49.65±26.95mlvs36.75±21.96ml，t=-1.546，P=0.131）和最大尿流率（3个月，12.36±2.63ml/svs13.60±2.82ml/s，t=1.361,P=0.182;12个月,12.18±3.14ml/svs11.13±3.01ml/s，t=-1.004,P=0.322)两组比较差异无统计学意义(P>0.05)。A组患者新的膀胱出口形态没有扭曲，连续性很好，相关并发症较少。
结论：尿道拖合吻合术组与常规吻合术组术后尿动力学参数无明显差异，术后新的膀胱出口状况良好，具有临床意义。
方法：江西省人民医院2016年6月至2021年1月对36例膀胱癌患者行腹腔镜膀胱根治性切除加回肠原位新膀胱重建术，其中16例患者行间歇性尿道吻合术。而20例患者接受了新膀胱-尿道拖曳和粘合吻合术。最大膀胱容量，残余尿量,最大尿流率,新膀胱颈的出口形态均在术后随访期间定期监测。
结果:术后3个月和12个月尿道拖合吻合术组(A组)与常规吻合术组(B组)无显著性差异,和最大膀胱容量（3个月，488.35±51.56mlvs481.06±40.61ml，t=-0.462,P=0.647;12个月,496.35±51.09mlvs476.56±56.33ml，t=-1.103,P=0.278),残余尿量（3个月，44.15±24.12mlvs38.69±21.82ml，t=-0.704,P=0.486;12个月,49.65±26.95mlvs36.75±21.96ml，t=-1.546，P=0.131）和最大尿流率（3个月，12.36±2.63ml/svs13.60±2.82ml/s，t=1.361,P=0.182;12个月,12.18±3.14ml/svs11.13±3.01ml/s，t=-1.004,P=0.322)两组比较差异无统计学意义(P>0.05)。A组患者新的膀胱出口形态没有扭曲，连续性很好，相关并发症较少。
结论：尿道拖合吻合术组与常规吻合术组术后尿动力学参数无明显差异，术后新的膀胱出口状况良好，具有临床意义。
