腹腔镜膀胱部分切除术治疗膀胱疾病及疗效观察  

Laparoscopic partial cystectomy for bladder disease

作　　者：尚吉文[1] 杨毅[1] 程晓萍[2] 姚雪[3] 成建军[1] 武进峰[1] 

机构地区：[1]山西医学科学院山西大医院泌尿外科,太原030027 [2]太原市中心医院妇产科 [3]山西医学科学院山西大医院供应室

出　　处：《微创泌尿外科杂志》2014年第4期205-207,共3页Journal of Minimally Invasive Urology

基　　金：山西省自然科学基金项目(2014011042-2)

摘　　要：目的:探讨腹腔镜膀胱部分切除术(LPC)治疗膀胱疾病的安全性和有效性.方法:回顾分析11例膀胱疾病患者(2例避孕环膀胱结石,2例膀胱憩室,7例膀胱肿瘤)行腹腔镜膀胱部分切除术(其中2例脐尿管癌行腹腔镜扩大膀胱部分切除术),并记录手术时间、出血量、围手术期并发症等指标.术后定期行膀胱镜检查并随访.结果:11例均手术成功,平均手术时间95 min(65～120 min),术中出血量52 ml(40～100 ml),术后住院时间7.5 d(6～11 d).标本采用标本袋自切口取出,标本均完整.腹腔引流管2～3 d拔除,术后8～10 d拔出尿管.术后随访8～30个月,平均18个月.术后结果,2例避孕环膀胱结石,2例膀胱憩室;术后病理:1例膀胱炎性肌纤维母细胞瘤,2例膀胱憩室,2例脐尿管癌,4例尿路上皮癌,2例为膀胱结石.1例脐尿管癌于术后16个月出现肿瘤局部复发及远处转移,保守治疗.无穿刺通道及腹腔种植转移.结论:腹腔镜膀胱部分切除术,腹腔镜膀胱部分切除术具有微创、失血少、恢复快、住院时间短、术后痛苦少、术野美观等优势,可作为治疗子宫穿人膀胱异物、膀胱憩室和膀胱良性肿瘤及经过筛选的膀胱恶性肿瘤一种安全、有效的手术方法.Objective:To evaluate the clinical value and feasibility of laparoscopic partial cystectomy in bladder disease.Methods:Laparoscopic partial cystectomy was performed for 11 cases of disease of bladder,it was retrospectively reviewed for the characters of pathologic features.2cases of urachal carcinoma and 2cases of benign bladder,6cases of malignancy tumour.All the cases were underwent transperitoneal laparoscopic partial cystectomy.Results:The produce was completed in all cases.Mean surgical time was 95minutes(60-120min)and mean blood loss was 52mL(40-100mL).Mean hospital stay was 7.5d(6-11d).Final result confirmed 2case of intrauterine device of bladder calculi;and histopathology confirmed2 case of vesical diverculum,1case of inflammatory myofibroblastic tumor(IMT),2cases of urachal carcinoma,4cases of malignancy tumour.There were no significant complications during both intraoperation and postoperation.Conclusions:Laparoscopic partial cystectomy is feasible and has many advantages of minimal trauma,early recovery,shorter hospital stay.It can be an alternative surgical method for treating patient with bladder diseases.

关 键 词：宫内节育环 膀胱结石 腹腔镜 膀胱部分切除术 膀胱肿瘤 

分 类 号：R694[医药卫生—泌尿科学]