腹腔镜与开放性根治性膀胱切除术治疗老年膀胱癌短期疗效对比研究  

Clinical efficacy of laparoscopic and open radical cystectomy for elderly patients with bladder cancer

作　　者：白云金 杨玉帛 韩平[1] 王晓明[1] 唐寅[1] 李金洪[1] 蒲春晓[1] 魏强[1] 

机构地区：[1]四川大学华西医院泌尿外科,四川成都610041

出　　处：《现代泌尿外科杂志》2016年第2期87-90,共4页Journal of Modern Urology

基　　金：国家自然科学基金(No.81270841);四川省科技厅科技支撑计划(No.2013SZ0034)

摘　　要：目的探讨和评价腹腔镜根治性膀胱切除术治疗老年(≥65岁)膀胱癌的临床疗效。方法回顾性分析华西医院2009年1月至2013年12月行根治性膀胱切除术治疗的膀胱癌患者73例临床资料,其中腹腔镜组30例,开放组43例。比较两组患者围手术期情况、术后并发症以及生存情况。结果与开放手术组相比,腹腔镜手术组手术时间明显延长(P<0.05),而术中失血量、输血例数及术后镇痛剂需要量均较少(P<0.05),术后恢复进食时间、下床活动时间和住院时间明显缩短(P<0.05),总体并发症发生率明显降低(P<0.05),主要体现在Clavien-DindoⅡ级发生率较低(P<0.05);两组肿瘤治疗效果相当(P>0.05)。结论与传统开放手术相比,对于老年膀胱癌,腹腔镜根治性膀胱切除术在能够保证肿瘤根治效果的同时,且具有耐受性好、安全、创伤小、出血少、术后恢复快等优点。Objective To evaluate the feasibility and efficacy of laparoscopic and open radical cystectomy for patients with bladder cancer who were older than65 years.Methods Clinical data of 73 patients with bladder cancer undergoing radical cystectomy during Jan.2009 to Dec.2013 were retrospectively reviewed.The patients were assigned to laparoscopic group（n=30）and open group（n=43）.The peri-operative index,postoperative complications,and survival rates were compared.Results Compared to open radical cystectomy,the mean operative time of laparoscopy surgery was significantly longer,the mean blood loss,number of patients who required blood transfusion,analgesic requirement,and overall incidence of complications were less,and the time to resumption of oral intake,postoperative ambulatory episode,and postoperative hospital stay were shorter in the laparoscopic group（all P〈0.05）.There were no major differences in oncologic outcomes between the two groups（P〉0.05）.Conclusions Laparoscopic cystectomy has similar oncologic outcomes to traditional radical cystectomy,while it also has advantages of better tolerance,safer therapy,fewer traumas,less bleeding,and more rapid recovery.

关 键 词：膀胱全切 腹腔镜 老年人 术后并发症 

分 类 号：R737[医药卫生—肿瘤]