腹腔镜膀胱癌根治术后回肠新膀胱与Bricker膀胱远期并发症及生活质量分析  

Comparative analyses of long-term complications and aquality of life of ileal new bladder and Bricker bladder after laparoscopic radical surgery for bladder cancer

作　　者：刘贝贝 郭园园 陈梦杰 高五岳 孙巍 王金行 LIU Beibei;GUO Yuanyuan;CHEN Mengjie;GAO Wuyue;SUN Wei;WANG Jinxing(Department of Urology,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院泌尿外科,安徽蚌埠233004

出　　处：《中华全科医学》2024年第5期738-741,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81702495);安徽省自然科学基金项目(18080850H279);安徽省高校自然科学研究项目(KJ2021A0706)。

摘　　要：目的比较分析原位回肠新膀胱术(IN)与Bricker回肠膀胱术(Bricker)术后远期并发症情况与生活质量,为个体化尿流改道方式提供选择依据。方法收集2020年1月—2022年12月蚌埠医科大学第一附属医院泌尿外科收治的行膀胱癌根治术男性患者60例。根据尿流尿道改道方式分为IN组34例和Bricker组26例。分析比较2组术后6个月、12个月的远期并发症情况与患者生活质量。结果2组手术时间与术中出血量差异无统计学意义(P>0.05),IN组术后肠道恢复时间与住院时间长于Bricker组(P<0.05);2组6个月总并发症(22例vs.14例)差异无统计学意义(P>0.05),12个月总并发症(19例vs.23例)差异有统计学意义(P<0.05);12个月上尿路积水情况IN组优于Bricker组(4例vs.9例P<0.05);2组生活质量6个月差异无统计学意义(P>0.05),12个月IN组生活质量显著高于Bricker组(142.82±6.42 vs.118.69±9.92,F=11.128,P<0.001)。结论IN对比Bricker具有更少的远期并发症与更高的生活质量,在尿流改道方式的选择中应予着重考虑。Objective To compare and analyze the long-term complications and quality of life in bladder cancer patients who suffered laparoscopic cystectomy and urinary diversion of in situ ileal neobladder(IN)or Bricker ileal orthotopic neobladder(Bricker),providing a basis for selecting individualized urinary diversion.Methods A total of 60 male patients who underwent radical cystectomy were collected in the Urology Department of the First Affiliated Hospital of Bengbu Medical University from January 2020 to December 2022.All patients were divided into the IN group(n=34)and the Bricker group(n=26)according to the methods of urinary diversion.The long-term complications and quality of life were analyzed at 6 months and 12 months after operation.Results There was no significant difference in both operation time and intraoperative blood loss between two groups(P>0.05),but the intestinal recovery time and hospital stay time of patients in IN group were significantly longer than those in Bricker group(P<0.05).There was no significant difference in the 6-month total complications between the 2 groups(22 cases vs.14 cases),P>0.05,but there was significant difference in the 12-month total complication rates(19 cases vs.23 cases),P<0.05.However,the upper urinary tract hydronephrosis was better in patients from IN group than those from Bricker group at 12 months(4 cases vs.9 cases,P<0.05).There was no significant difference IN QOL between the two groups at 6 months(P>0.05),and QOL in the 12 months group was significantly higher than that in the Bricker group(142.82±6.42 vs.118.69±9.92,F=11.128,P<0.001).Conclusion Fewer long-term complications and higher quality of life are demonstrated in IN,which should be considered seriously when choosing urinary diversion methods.

关 键 词：腹腔镜膀胱癌根治术 回肠新膀胱 Bricker回肠膀胱 远期并发症 生活质量 

分 类 号：R737.14[医药卫生—肿瘤] R730.56[医药卫生—临床医学]