三孔三层面法保留前列腺包膜的腹腔镜膀胱根治性切除+Studer膀胱术的初步探讨  

The evaluation of prostate capsule sparing laparoscopic radical cystectomy with Studer orthotopic ileal neobladder by three ports three layers approach

作　　者：林光正 毕良宽[1] 王进有[1] 彭龙飞 唐亮 Lin Guangzheng;Bi Liangkuan;Wang Jinyou;Peng Longfei;Tang Liang(Department of Urology,the Second Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院泌尿外科,合肥230601

出　　处：《中国临床保健杂志》2021年第5期702-705,共4页Chinese Journal of Clinical Healthcare

基　　金：安徽省自然科学基金项目(2108085MH297);安徽医科大学第二附属医院临床研究培育计划项目(2020LCZD16)。

摘　　要：目的探讨三孔三层面法保留前列腺包膜的腹腔镜膀胱根治性切除+Studer膀胱术的手术方法及临床疗效。方法2017年6月至2021年5月,安徽医科大学第二附属医院收治的行腹腔镜膀胱根治性切除+Studer膀胱术39例患者,其中23例膀胱癌患者均按照标准化流程行三孔外侧入路三层面法保留前列腺包膜的腹腔镜膀胱根治性切除+Studer膀胱术,另16例按照常规方法行五孔腹腔镜膀胱根治性切除+Studer膀胱术,对患者手术相关资料、排尿情况、勃起功能、肿瘤控制情况等情况进行定期随访。结果手术均顺利完成,改良组手术时间为(285.17±39.61)min,较常规组(325.18±68.82)min明显缩短(P<0.05),改良组的尿控率及勃起正常率明显优于常规组(P<0.05),改良组1例患者术后病理提示前列腺癌,目前随访观察,未见肿瘤进展。结论三孔三层面法保留前列腺包膜的腹腔镜膀胱根治性切除+Studer膀胱术是安全可行的,较传统方法缩短了手术时间,显著提高患者的尿控能力以及性功能,近期有良好的肿瘤控制效果。Objective To investigate the experience and clinical effects of prostate capsule sparing laparoscopic radical cystectomy with Studer orthotopic ileal neobladder by three ports three layers approach.Methods From June 2017 to May 2021,39 patients received laparoscopic radical cystectomy and Studer bladder in the Second Affiliated Hospital of Anhui Medical University,23 patients underwent prostate capsule sparing laparoscopic radical cystectomy with Studer pouch by three ports three layers approach according to a standardized procedure.16 cases underwent conventional laparoscopic radical cystectomy with Studer bladder.All patients were followed up and information including operation,urination,sexual function and tumor control were recorded.Results The operations were finished successfully.The average operation time of the modified cystectomy group was(285.17±39.61)minutes,which was shorter than that in the conventional group(P<0.05).The urinary function and sexual function of the modified group was significantly better than the conventional group(P<0.05).One incidental prostate cancer was found in the modified group.At present,no recurrence or distant metastasis was found.Conclusions Prostate capsule sparing laparoscopic radical cystectomy with Studer orthotopic ileal neobladder by three ports three layers approach is safe and feasible.The operation time is shortened.Sexual function and urinary function are improved significantly.The oncological outcomes need the long-term follow up.

关 键 词：三孔法 保留前列腺包膜 膀胱根治性切除 Studer膀胱术 勃起功能 尿控功能 

分 类 号：R737.14[医药卫生—肿瘤]