膀胱软镜联合腹腔镜膀胱部分切除术治疗肌层浸润性膀胱癌11例  

Flexible Cystoscopy Combined with Laparoscopic Partial Cystectomy for Muscle-invasive Bladder Cancer

作　　者：袁道彰[1] 徐晓龙 王丽艳[1] 都兴华[3] 李靖[1] 郑舜升 杨建安[1] 王斌[1] 

机构地区：[1]广州医科大学附属肿瘤医院泌尿外科,广州510095 [2]东莞市第三人民医院泌尿外科,东莞523366 [3]暨南大学附属第一医院泌尿外科,广州510630

出　　处：《中国微创外科杂志》2017年第8期754-756,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：广东省医学科学技术研究基金项目(项目编号:A2016611)

摘　　要：目的探讨膀胱软镜联合腹膜外腹腔镜膀胱部分切除术治疗肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)的可行性。方法2014年10月~2015年12月采用膀胱软镜联合腹膜外腹腔镜膀胱部分切除术(laparoscopic partial cystectomy,LPC)治疗11例MIBC,术中膀胱软镜检查,行腹膜外LPC和腹腔镜下膀胱切口缝合术。结果 11例手术均成功,无中转开放手术。平均手术时间155 min(125~190 min),术中平均出血量80 ml(20~150 ml),术后平均胃肠功能恢复时间30 h(20~56 h),术后平均住院8 d(5~11 d)。无尿漏、肠粘连和肠梗阻并发症发生。术后病理:pT_2N_0M_06例,pT_3N_0M_05例。11例术后随访3~16个月,平均10个月,膀胱内复发1例,远处转移1例。结论膀胱软镜联合LPC治疗MIBC可行、安全。Objective To study the feasibility of flexible cystoscopy combined with laparoscopic partial cystectomy（ LPC） for muscle-invasive bladder cancer（ MIBC）. Methods We retrospectively reviewed 11 patients with MIBC treated with flexible cystoscopy combined with LPC from October 2014 to December 2015. The treatment included intraoperative flexible cystoscopy examination,extraperitoneal LPC,and laparoscopic bladder incision suture. Results The 11 patients were operated successfully,and no conversion to open surgery was required. The average intra-operative time was 155 min（ range,125-190 min）,the average intraoperative blood loss was 80 ml（ range,20-150 ml）,the average postoperative gastrointestinal function recovery time was 30 h（ range,20-56 h）,and the average hospitalization time was 8 d（ range,5-11 d）. No urinary fistula,intestinal adhesion or obstruction occurred. The postoperative pathological results showed 6 cases of pT_2N_0M_0 and 5 cases of pT_3N_0M_0. Postoperative followups for 3-16 months（ mean,10 months） in the 11 cases showed 1 case of bladder recurrence and 1 case of distant metastasis.Conclusion Flexible cystoscopy combined with LPC is a feasible,safe,and effective method of minimally invasive surgery for MIBC.

关 键 词：腹腔镜膀胱部分切除术 膀胱软镜 尿路上皮细胞癌 

分 类 号：R737.14[医药卫生—肿瘤]