3D腹腔镜与普通腹腔镜、开放根治性膀胱切除+肠道原位新膀胱术围手术期疗效的比较  

Comparison of perioperative efficacy among 3D laparoscopy,laparoscopy and open radical cystectomy

作　　者：夏照明 土应果 郭民 杨建昌 李智斌 李元 杨旺秋 XIA Zhaoming;TU Yingguo;GUO Min;YANG Jianchang;LI Zhibin;LI Yuan;YANG Wangqiu(Department of Urology, Dali Bai Autonomous Prefecture People's Hospital, Dali 671000, China)

机构地区：[1]大理白族自治州人民医院泌尿外科,671000

出　　处：《现代泌尿生殖肿瘤杂志》2021年第2期71-75,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的比较3D腹腔镜根治性膀胱切除术(3D-LRC)、腹腔镜根治性膀胱切除术(LRC)和开放根治性膀胱切除术(ORC)的疗效及围手术期并发症的发生差异。方法回顾性分析大理白族自治州人民医院2008年9月至2020年6月行膀胱根治性切除术(RC)的患者资料,共148例,其中行ORC术62例、行LRC术32例、行3D-LRC术54例。对比3组患者的膀胱切除时间、淋巴结清扫时间、淋巴结清扫数目、术中出血量、围手术期并发症的发生情况、术后住院天数以及新膀胱尿控的差异。结果3D-LRC组术中出血量明显小于LRC组及ORC组,3D-LRC组术后住院时间及排气时间明显短于ORC组(P<0.05),3D-LRC组膀胱切除时间以及淋巴结清扫时间短于LRC组(P<0.05),淋巴结清扫数目多于ORC组(P<0.05)。3组患者围手术期并发症的发生率以及新膀胱尿控方面比较无明显差异(P>0.05)。结论3D-LRC术具有出血少、手术时间短、淋巴结清扫更彻底、术后恢复快、术后住院时间短的优势,在没有条件购买机器人的基层医院是一种不错的选择。Objective To compare the efficacy and perioperative complications among 3D laparoscopic radical cystectomy(3D-LRC),laparoscopic radical cystectomy(LRC)and open radical cystectomy(ORC).Methods We retrospectively analyzed the data of patients undergoing radical bladder resection in Dali Bai Autonomous Prefecture People's Hospital from September 2008 to June 2020.There were 148 cases in total,including 62 cases of open surgery,32 cases of laparoscopic surgery,and 54 cases of 3D laparoscopic surgery.The cystectomy time,lymph node dissection time,number of lymph node dissection,intraoperative blood loss,occurrence of perioperative complications,postoperative hospital stay and urinary control of new bladder were compared among the three groups.Results The intraoperative blood loss in the 3D-laparoscopic group was significantly lower than that in the laparoscopic group and the open surgery group,and the postoperative hospital stay and exhaust time in the 3D-laparoscopic group were significantly shorter than those in the open surgery group(P<0.05).The cystectomy time and lymph node dissection time in the 3D-laparoscopic group were shorter than those in the ordinary laparoscopic group(P<0.05).The number of lymph nodes dissected was more than that of open surgery(P<0.05).There was no significant difference in the incidence of perioperative complications or urinary control of new bladder among three groups(P>0.05).Conclusions Three dimensional-LRC has the advantages of less bleeding,shorter operation time,more thorough lymph node dissection,faster postoperative recovery and shorter postoperative hospitalization time,so it is a good choice in basic hospitals that cannot afford to buy robots.

关 键 词：膀胱癌 3D腹腔镜 根治性膀胱切除术 

分 类 号：R73[医药卫生—肿瘤]