Post-Operative Evaluation Of The Orthotopic Continent Neobladder Using Complete Detenial Sigmoid Colon And Study Of The Microstructure Of The Neobladder Mucosa

Objective Evaluate the post-operative efficience of orthotopic complete detenial sigmoid neobladder. The change of the neobladder mucosa in different post-operative period was observed by light telescope and TEM and SEM Methods 1.Inventory those patients who sustained the operation by questionnaire every 3 months . 2.1n 30 patients who lived near our hospital,Blood and urine routine\blood biochemical\KUB and IVP have been examinated every 3 months. The cystoscope were proceed in same time.Volume-Pressure also were assayed. Some of the bladder mucosa were superscripted for observation. Results No surround operation period death case and reoperative case . 2 patients were died from neoplasm relapse after 1 year of operation . 2 patients were died from heart and cerebrovascular disease . The daytime continence rate has been 100% and the nighttime continence rate 80% . All the patients get daytime continence in 15 days after the urine tubes were pulled out . There were 6-12 times mictions in daytime and 1-4 times mictions in nighttime . Hyperehloremic acidosis has been observed in 1 patients. Stone has been observed in 2 patients and the stenosis of intrareservoir-urethra anastomotic stoma has been observed in 1 patients by cystoscope . Evidence of ureteral reflux occurred in 4 cases . The capacity of the urine reservoir has been 220-3 70ml (averaged 320ml),the average intrareservoir pressure 24.86cmH2O . There were no obvious changes in sigmoid bladder by light telescope except for phlogosis cells infilteation . The microvillus appered to be rarefaction and lodging or convoluting by TEM after half a year . The excretion of mucus decreased with the time elongated . Mocosa cells appeared to be some characteric changes by TEM,Involve cleavage phas increased,dedifferentiation,the ratio increased of nucleolus and cell plasm . Conclusions Continent orthotopic complete detenial sigmoid colon neobladder is fairly good for urinary diversion with highly living quality and is highly recommended . The ultrastructure changes of complete detenial sigmoid pouch mucusa in 2 years after operation are almost the same comparing with literatures .