腹腔镜与开放性根治性膀胱全切除术治疗老年膀胱癌的疗效及对尿动力学的影响  

Efficacy of laparoscopic and open radical cystectomy in the treatment of bladder cancer in elderly patients and the effect on urodynamics

作　　者：李征[1] 牛桂林[2] 康梅娟[3] 杨立新[1] LI Zheng;NIU Guilin;KANG Meijuan;YANG Lixin(Department of Urologic Surgery,Nanyang Central Hospital,Nanyang 473000,He’nan,China;Hospital Infection Office,Nanyang Central Hospital,Nanyang 473000,He’nan,China;Department of Neurology,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院泌尿外科,河南南阳4730000 [2]南阳市中心医院院感办,河南南阳4730000 [3]南阳市中心医院神经内科,河南南阳4730000

出　　处：《癌症进展》2020年第11期1171-1173,共3页Oncology Progress

摘　　要：目的探讨腹腔镜与开放性根治性膀胱全切除术治疗老年膀胱癌的疗效及对尿动力学的影响。方法将98例老年膀胱癌患者随机分为观察组(行腹腔镜根治性膀胱全切除术)和对照组(行开放性根治性膀胱全切除术),每组49例,记录围手术期相关参数,并于术后3个月采用尿动力学分析仪检测尿动力学参数,同时记录术后并发症的发生情况。结果两组患者淋巴结清扫数目及手术时间比较,差异均无统计学意义(P﹥0.05);观察组患者术中出血量明显少于对照组,肠道功能恢复时间及住院时间明显短于对照组,差异均有统计学意义(P﹤0.01)。术后3个月,两组患者最大膀胱容量、残余尿量、最大尿道压力、充盈期膀胱压力、最大尿流率比较,差异均无统计学意义(P﹥0.05)。两组患者术后均出现肠瘘、肠梗阻、吻合口狭窄、尿路感染及尿失禁并发症,观察组患者并发症总发生率低于对照组,差异有统计学意义(P﹤0.05)。结论腹腔镜根治性膀胱全切除术治疗老年膀胱癌具有术中出血量少、肠道功能恢复时间短、住院时间短、并发症发生率低等优势,有利于患者术后恢复,且术后尿动力学参数与开放性根治性膀胱全切除术基本一致。Objective To investigate the efficacy of laparoscopic and open radical cystectomy in the treatment of bladder cancer in elderly patients and the effect on urodynamics.Method Ninety-eight patients with bladder cancer were randomly divided into study group(with laparoscopic radical cystectomy)and control group(with open radical cystectomy),with 49 cases in each group.The perioperative surgical indicators in both groups were recorded,and urodynamics measures were analyzed 3 months after surgery,besides,the incidence of postoperative complications were also assessed.Result There was no significant difference in the number of lymph node dissection and operative time between the two groups(P>0.05);significantly less blood loss,shorter recovery time of intestinal functions,and decreased length of hospital stay were observed in study group compared to control group,and the differences were of statistical significance(P<0.01).At 3 months post-surgery,the maximum bladder volume,residual urine volume,maximum urethral pressure,bladder pressure during filling,and maximum urinary flow rate were similar between the two groups(P>0.05).The overall incidence of complications after cystectomy via either approach was significantly lower than that of open radical cystectomy(P<0.05).Conclusion Laparoscopic radical cystectomy has the advantages of inducing less intraoperative blood loss,shorter recovery time of intestinal function,shorter hospital stay and lower complication rate in the treatment of elderly patients with bladder cancer,facilitating the postoperative recovery of patients,with basically analogous urodynamics compared with open radical cystectomy.

关 键 词：膀胱癌 腹腔镜根治性膀胱全切除术 开放性根治性膀胱全切除术 尿动力学 

分 类 号：R737.14[医药卫生—肿瘤]