腹腔镜根治性膀胱切除术中DVC的解剖及处理  

Dissection and management of DVC during laparoscopic radical cystectomy

作　　者：王诗扬 李炯明[1] 刘建和[1] 赵润恒 王光[1] 李沛[1] 石鑫[1] WANG Shiyang;LI Jiongming;LIU Jianhe;ZHAO Runheng;WANG guang;LI pei;SHI xin(Department of Urology, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,650101

出　　处：《现代泌尿生殖肿瘤杂志》2020年第2期92-94,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨腹腔镜根治性膀胱切除术中安全处理背静脉复合体(DVC)的手术方法。方法选取2013年1月至2018年12月在我院行腹腔镜根治性膀胱切除术的162例膀胱癌患者。处理DVC的手术要点为:充分显露耻骨后间隙,从耻骨前列腺韧带两侧切开盆内筋膜,游离出两侧DVC外侧壁,切断部分耻骨前列腺韧带,精准解剖,完全暴露出DVC,双重缝扎后将之切断。结果162例患者均实施了腹腔镜根治性膀胱切除术,无中转开放手术。术中均完成了对DVC的精准解剖、缝扎和切断。处理DVC手术时间8~15 min,平均10 min,出血量10~120 ml,平均25 ml。术中、术后均未输血。结论腹腔镜根治性膀胱切除术中,采用对DVC进行精准解剖、缝扎后切断的手术方法,可有效减少术中处理DVC的出血。Objective To explore the safe and effective management of dorsal vein complex(DVC)during laparoscopic radical cystoprostatectomy.Methods From January 2013 to December 2018,162 patients with bladder cancer underwent laparoscopic radical cystectomy.The key steps during management of DVC were:fully expose the posterior pubic space,incise the endopelvic fascia from both sides of the puboprostatic ligament,free the lateral wall of DVC from both sides,.DVC was then exposed completely.Double sutures were applied and DVC was cut.Results All 162 patients underwent laparoscopic radical cystectomy without conversion to open surgery.Accurate anatomy,suture and amputation of DVC were performed during the operation.The time dealing with DVC was about 8-15 minutes,averaging 10 minutes.Bloos loss was 10-120 ml,averaging 25 ml.There was no blood transfusion during and after operation.Conclusions In laparoscopic radical cystectomy,precise anatomy and resection of DVC after applying suture can effectively reduce the bleeding from DVC.

关 键 词：腹腔镜 根治性膀胱切除术 背静脉复合体 处理 

分 类 号：R73[医药卫生—肿瘤]