完全腹腔镜膀胱根治性切除回肠膀胱术治疗膀胱癌25例疗效观察  

Efficacy of total laparoscopic radical cystectomy with intracorporeal ileal conduit urinary diversion:a report of 25 cases

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作  者:王思豪 范博涵 徐岳[1] 宋黎明[1] 周晓光[1] 胡小鹏[1] 王伟[1] WANG Sihao;FAN Bohan;XU Yue;SONG Liming;ZHOU Xiaoguang;HU Xiaopeng;WANG Wei(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区:[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020

出  处:《现代泌尿外科杂志》2024年第4期312-316,共5页Journal of Modern Urology

摘  要:目的探讨完全腹腔镜膀胱根治性切除回肠膀胱术的临床效果和手术技巧,以期为膀胱癌患者手术方式的选择提供参考。方法回顾性分析首都医科大学附属北京朝阳医院泌尿外科2017年3月—2022年8月收治的48例行腹腔镜膀胱根治性切除回肠膀胱术治疗膀胱癌患者的临床资料。按照手术方式分为传统腹腔镜组(腹腔镜膀胱根治性切除+脐下正中切口回肠膀胱术)患者23例,完全腹腔镜组25例。比较两组患者的手术时间、估计出血量、术后肠道功能恢复时间、引流管拔除时间及住院时间。结果48例患者手术均顺利完成,所有患者均未发生Clavien-Dindo>3级并发症。传统腹腔镜组与完全腹腔镜组的手术时间分别为(227.0±46.4)min与(253.6±58.9)min,出血量分别为(131.7±79.8)mL与(154.0±93.0)mL,两组术后肠道功能恢复时间、引流管拔除时间比较差异无统计学意义(P>0.05),而完全腹腔镜组的术后住院时间较传统腹腔镜组更短,差异有统计学意义(P=0.035)。结论完全腹腔镜膀胱根治性切除回肠膀胱术安全可行,与传统腹腔镜手术方式效果相当,而完全腹腔镜组术后住院时间更短,有利于术后快速康复。Objective To investigate the efficacy and surgical technique of total laparoscopic radical cystectomy with intracorporeal ileal conduit urinary diversion,so as to provide reference for the selection of surgery for patients with bladder cancer.Methods Clinical data of 48 patients with bladder cancer who underwent laparoscopic radical cystectomy during Mar.2017 and Aug.2022 in our hospital were retrospectively analyzed,including 23 cases who received traditional laparoscopic radical cystectomy combined with extracorporeal ileal conduit,and 25 who received total laparoscopic radical cystectomy with intracorporeal ileal conduit.The operation time,blood loss,postoperative intestinal function recovery time,drainage tube removal time and hospital stay were compared between the two groups.Results All procedures were successfully performed,and no Clavien-Dindo>grade 3 complications were observed.The operation time,and amount of estimated blood loss of the traditional group and total laparoscopic radical group were(227.0±46.4)min vs.(253.6±58.9)min,and(131.7±79.8)mL vs.(154.0±93.0)mL,respectively.There were no differences in postoperative intestinal function recovery time and drainage tube removal time(P>0.05).The hospital stay was shorter in the total laparoscopic radical group than in the traditional group(P=0.035).Conclusion Total laparoscopic radical cystectomy with intracorporeal ileal conduit urinary diversion is safe and feasible.which is comparable to the traditional laparoscopic surgery,while the hospital stay in the total laparoscopic group is shorter,which is conducive to rapid postoperative recovery.

关 键 词:完全腹腔镜 膀胱癌 尿流改道 回肠通道术 膀胱根治性切除术 

分 类 号:R737.14[医药卫生—肿瘤]

 

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