人工膀胱術後及相關併發症之處理-病例討論
黃國財1林威宇1邱國雄2林健輝1黃雲慶1 何東儒1陳志碩1
嘉義長庚記念醫院泌尿外科1；嘉義長庚記念醫院手術專責護理師2
The management of the complication of post neobladder reconstruction- case report
Kuo-Tsai Huang 1, Wei-Yu Lin1, Kuo-Hsiung Chiu2
Jian-Hui Lin 1, Yung-Chin Huang1, Dong-Ru Ho1, Chih-Shou Chen1
1Division of Urology, Chang-Gung Memorial Hospital at Chia-Yi, Taiwan
2Operative assistance nurse, Chang-Gung Memorial Hospital at Chia-Yi, Taiwan
We reported 3 patients receiving laparoscopic radical cystectomy with orthotopic ileal neobladder reconstruction(M pouch).
Case 1: 56 y/o male had ureter-pouch disruption due to ureter stent dislocation , and he received open surgical revision and reanastomosis . However , colon perforation followed after second operation .
Case 2: 51 y/o female had uretero-pouch anastomotic stricture four months later , and percutaneous nephrostomy with zebraguide wire antegrade insertion into neobladder was performed first then followed endoscopic ureter internal dilatation and catheter indwelling .
Case 3: 47 y/o male also had uretero-pouch anastomotic stricture , but endoscopic dilatation failed . He finally received laparoscopic ureter adhesion-lysis and ureteroneocystostomy under mini-open wound .