Basic Research for Establishment of Ideal Orthotopic Neobladders. -Investigation using a computer simulating model-

建立理想原位新膀胱的基础研究。

基本信息

批准号：
09671627
负责人：
OKADA Hiroshi
金额：
$ 2.18万
依托单位：
Kobe University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671627/
关键词：
orthotopic neobladder bladder cancer voiding function incontinence hypercontinence bone density calcium metabolism OOL

项目摘要

1.Voiding functions of several types of orthotopic neobladdersWe investigated voiding functions of 30 men who underwent orthotopic neobladder replacement after radical cystectomy due to invasive bladder cancers. Colonic Neobladder (CN) was created in 7 patients, ileocolic neobladder (ICN) in 10 patients, ileal neobladder (IN) in 10 patients, and sigmoid colonic neobladder (SCN) in 3 patients, and all were followed at least 5 years after surgery. Daytime continence was obtained in more than 90% in any type of neobladder, however, nocturnal continence was achieved better in patients with IN than other neobladders using colonic segments. This phenomenon is better compliance of the neobladder using ileal segment than those using colonic segments.2.Voiding functions in female patients with orthotopic neobladderIndication of orthotopic neobladder replacement was expanded to the female patients. We analyzed the voiding functions of female patients who underwent orthotopic neobladder replacement with CN(2), ICN(2), and IN(4). Continence was achieved satisfactorily, however, those with IN became hypercontinent and required clean intermittent catheterization. Thus for female patients neobladder using colonic segments is rationale.3.Calcium metabolism in the patients with orthotopic neobladdersCalcium metabolism and bone mineral density were measured in patients with orthotopic neobladders ; CN(2), ICN(8), and SCN(23). Patients with orthotopic neobladder were suffered from metabolic acidosis and demineralization of the bones to various extent. This phenomenon, if very slight, may become serious drawback of the orthotopic neobladder replacement. Thus we propose to start investigation to utilize tissue engineering technology to recreate true bladders.

1.几种原位新膀胱的排尿功能我们调查了30名因浸润性膀胱癌在根治性膀胱切除术后接受原位新膀胱置换术的男性的排尿功能。 7 名患者创建了结肠新膀胱 (CN)，10 名患者创建了回结肠新膀胱 (ICN)，10 名患者创建了回肠新膀胱 (IN)，3 名患者创建了乙状结肠新膀胱 (SCN)，所有患者术后均随访至少 5 年。任何类型的新膀胱的日间节制率均超过 90%，然而，IN 患者的夜间节制效果优于使用结肠段的其他新膀胱。这一现象是回肠段新膀胱顺应性优于结肠段新膀胱。2.原位新膀胱女性患者的排尿功能原位新膀胱置换适应证扩大到女性患者。我们分析了接受 CN(2)、ICN(2) 和 IN(4) 原位新膀胱置换术的女性患者的排尿功能。尿失禁的效果令人满意，然而，IN 患者的尿失禁变得过度，需要清洁的间歇性导尿。因此对于女性患者使用结肠段进行新膀胱治疗是合理的。3.原位新膀胱患者的钙代谢测定原位新膀胱患者的钙代谢和骨密度。 CN(2)、ICN(8) 和 SCN(23)。原位新膀胱患者存在不同程度的代谢性酸中毒和骨骼脱矿。这种现象如果非常轻微，可能会成为原位新膀胱置换术的严重缺陷。因此，我们建议开始研究利用组织工程技术来重建真正的膀胱。