3D腹腔镜根治性膀胱切除、回肠原位尿流改道术  

Radical Cystectomy and Orthotopic Urinary Diversion with 3D Laparoscopy

作　　者：胡新一[1] 李炯明[1] 刘建和[1] 方克伟[1] 王光[1] 崔茂荣[2] 孙洵 周洪庆[2] HU Xin-yi LI Jiong-ming LIU Jian-he FANG Ke-wei WANG Guang CUI Mao-rong SUN Xun ZHOU Hong-qing(The 2nd Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101 The First Hospital of Kunming, Kunming Yunnan 650011 The First Hospital of Qujing, Qujing Yunnan 655000, China)

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101 [2]昆明市第一人民医院,云南昆明650011 [3]曲靖市第一人民医院,云南曲靖655000

出　　处：《昆明医科大学学报》2016年第7期99-102,共4页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学联合专项基金资助项目(2013FB162)

摘　　要：目的探讨3D腹腔镜根治性膀胱肿瘤切除、原位尿流改道手术的临床效果．方法采用3D腹腔镜对6例男性膀胱癌患者进行根治性膀胱切除、原位尿流改道手术，创立通道后游离输尿管，结扎髂内动脉分支后清扫盆腔淋巴结，切断膀胱侧韧带、前列腺侧血管蒂以及背静脉复合体，制作新膀胱后吻合．结果手术时间290～350min，其中根治手术时间145～170min，根治手术出血40～150mL，患者均未输血．无盆腔重要血管损伤、直肠损伤等严重并发症发生．术后无肠吻合口瘘、新膀胱瘘、肠梗阻、伤口感染等发生．结论3D腹腔镜的三维立体成像，可有效消除2D腹腔镜术中的视角误差，使手术操作更加精细和精准，手术质量进一步提高．Objective To study the clinical effect of radical cystectomy and orthotopic urinary diversion with 3D laparoscopy. Methods We adopted 3D laparoscopy to do 6 cases of radical cystectomy and orthotopic urinary diversion from September 2014 to November 2015. After creating the channels, we isolated the ureter first, after ligating the branches of internal iliac artery we did the pelvic lymph node dissection, cut off the lateral bladder ligaments, lateral prostate vascular pedicles and dorsal vein complex, then reconstructed the new bladder and anastomose. Results The operation time was 290 ~ 350 min, in which the radical surgery time was 145 - 170 min and the bleeding was 40 ~ 150 ml without blood transfusion. No serious complications such as pelvic vascular injury and rectal injury occurred during operation. No intestinal anastomotic fistula, the new bladder fistula, intestinal obstruction, and wound infection occurred after the surgery. Conclusions Three-dimensional imaging completed by the 3D laparoscopy can effectively eliminate the vision disparity compared with 2D laparoscopy, and make the operation more accuracy. Therefore it can effectively shorten the operation time and learning curve.

关 键 词：3D腹腔镜 膀胱癌 根治性切除 原位尿流改道 

分 类 号：R737.14[医药卫生—肿瘤]