机器人辅助腹腔镜下膀胱癌根治术中先后行标准淋巴结清扫的近期疗效对比  

Comparison of short-term efficacy in standard pelvic lymph node dissection before and after robot-assisted radical cystectomy

作　　者：韦飞 王晶运 王帅[1] 祁小龙[1] 张大宏[1] WEI Fei;WANG Jingyun;WANG Shuai;QI Xiaolong;ZHANG Dahong(Department of Urology,Zhejiang Provincial People's Hospital,Hangzhou 310000,China;不详)

机构地区：[1]浙江省人民医院泌尿外科,杭州310000 [2]蚌埠医学院研究生院

出　　处：《现代泌尿生殖肿瘤杂志》2022年第2期82-86,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探究机器人辅助腹腔镜下膀胱癌根治术(Bricker术)中先后行标准盆腔淋巴结清扫术(sPLND)的近期疗效。方法回顾性分析2014年10月至2020年10月在浙江省人民医院接受机器人辅助腹腔镜下Bricker术中加行sPLND的115例肌层浸润性膀胱癌患者的临床资料。由两位主刀医生分别实施先清扫淋巴结(A组)和后清扫淋巴结(B组)。其中A组60例,B组55例。对比两组患者的手术时间、术中出血量、淋巴结清扫总数、拔管时间、术后进食时间、术后住院时间、术后并发症及短期随访情况,并运用非参数检验、t检验及卡方检验进行分析。结果两组手术均顺利完成,均无中转开放。A组和B组的淋巴结清扫数分别为(10.40±1.65)个和(14.67±2.30)个,拔管时间分别为(5.37±0.95)d和(7.03±0.96)d,术后住院时间分别为(10.00±1.95)d和(15.00±2.32)d,两组比较差异有统计学意义(P<0.05)。两组患者的手术时间、术中出血量、术后进食时间、手术前后肌酐差、手术前后血红蛋白差、术后并发症发生率、围手术期输血比例比较差异均无统计学意义(P>0.05)。两组患者随访3个月至1年,均无肿瘤复发及远处转移。结论机器人辅助腹腔镜下Bricker术先后行sPLND比较,后清扫淋巴结可切除更多淋巴结,但其拔管时间及住院时间会更长;短期随访资料显示,两种清理盆腔淋巴结手术方式在熟练掌握手术技巧后均安全有效。Objective To compare the short-term curative effect of standard pelvic lymph node dissection(sPLND)before and after radical bladder cancer resection under robot-assisted laparoscopy.Methods We retrospectively analysed 115 cases of muscle-invasive bladder cancer who underwent robot-assisted laparoscopic radical cystectomy plus sPLND in Zhejiang Provincial People's Hospital from October 2014 to October 2020.Two chief surgeons respectively performed lymph node dissection before total cystectomy(60 patients in group A)and lymph node dissection after total cystectomy group(55 patients in group B).Operation time,intraoperative blood loss,total number of lymph node dissections,extubation time,postoperative eating time,postoperative hospital stay,perioperative blood transfusion,postoperative complications,and short-term follow-up data were compared between two groups and the clinical data were analyzed using statistical non-parametric tests,t-tests and chi-square tests.Results The operations in both groups were successfully completed,and none of them was transferred to open surgery.The average number of total lymph node dissections in group A and group B were(10.40±1.65)and(14.67±2.30),the average extubation time were(5.37±0.95)d and(7.03±0.96)d,and the average postoperative hospital stay were(10.00±1.95)d and(15.00±2.32)d.The above data showed statistically significant difference between the two groups(P<0.05).However,operation time,intraoperative blood loss,postoperative eating time,the change of creatinine before and after the operation,the change of hemoglobin before and after surgery,the postoperative complication rates,and the perioperative blood transfusion ratio showed no statistical significance between two groups(P>0.05).Both groups were followed up for 3 months to 1 year,and there was no tumor recurrence or distant metastasis.Conclusions More lymph nodes can be removed in sPLND after robot-assisted laparoscopic radical cystectomy,but the extubation time and hospital stay were longer.However,short-term fo

关 键 词：机器人辅助下腹腔镜 膀胱肿瘤 全膀胱切除术 淋巴结清扫术 

分 类 号：R73[医药卫生—肿瘤]