经腹膜外途径腹腔镜根治性膀胱切除Bricker术的初步体会  

An initial experience of extraperitoneal laparoscopic radical cystectomy and Bricker operation

作　　者：熊丙建[1] 陶光晶 余义[1] 谢蛟魁 王晓 江铎[1] XIONG Bingjian;TAO Guangjing;YU Yi;XIE Jiaokui;WANG Xiao;JIANG Duo(Department of Urology,Ankang Central Hospital,Ankang 725000,China)

机构地区：[1]安康市中心医院泌尿外科,陕西安康725000

出　　处：《现代泌尿外科杂志》2021年第7期597-600,共4页Journal of Modern Urology

摘　　要：目的探讨经腹膜外途径腹腔镜膀胱根治性切除Bricker术的可行性及安全性。方法选择2020年3—12月安康市中心医院收治的6例肌层浸润性膀胱癌患者,年龄65-84岁,平均(72.5±8.2)岁,建立腹膜外腔隙后,顺行+逆行法行腹腔镜膀胱根治性切除术,再延长正中切口行尿流改道Bricker术。观察患者手术时间、出血量、术后肠功能恢复时间等指标,术后电话随访及定期返院行胸、腹、盆腔CT影像学检查及血常规等生化检查。结果6例患者手术均成功,无中转开放手术。腹腔镜手术时间150-210 min,平均(174.0±23.0)min;术中出血量200-600 mL,平均(300.0±176.2)mL;术后肠功能恢复时间2-3 d,平均(2.2±0.5)d。结论随着手术经验的积累,手术时间、出血量可逐步减少,经腹膜外途径腹腔镜膀胱根治性切除联合Bricker术具有良好的安全性及可行性。Objective To explore the feasibility and safety of extraperitoneal laparoscopic radical cystectomy(ELRC)and Bricker operation.Methods From Mar.2020 to Dec.2020,6 patients with muscle-invasive bladder cancer(MIBC)were selected,age range 65 to 84 years(mean 72.5±8.2).After the establishment of extraperitoneal space,anterograde plus retrograde laparoscopic radical cystectomy(LRC)was performed,and the median incision was extended to perform Bicker operation.The operation time,blood loss and postoperative intestinal function recovery time were observed.After operation,patients were regularly followed up with telephone calls or returned to hospital for chest,abdomen,pelvic CT,blood routine and biochemical reexaminations.Results All operations were successful,and there was no conversion to open operation.The laparoscopic operation time was 150-210(mean 174.0±23.0)minutes.The intraoperative blood loss was 200-600(mean 300.0±176.2)mL.The recovery time of intestinal function was 2-3(mean 2.2±0.5)days.Conclusion With the accumulation of surgical experience,the operation time and bleeding volume can be gradually reduced.ELRC plus Bricker operation is safe and feasible.

关 键 词：腹腔镜 腹膜外途径 根治性膀胱切除术 回肠膀胱术 肌层浸润性膀胱癌 

分 类 号：R737.14[医药卫生—肿瘤]