腹膜外途径腹腔镜保留女性内生殖器官膀胱全切原位回肠新膀胱术疗效分析  

Clinical effects with extraperitoneal laparoscopic radical cystectomy with pelvic organ-preserving and orthotopic neobladder techniques for bladder cancer in female patients

作　　者：蒋在庆 王科[1] 朱冠群[1] 赵凯[1] 尹心宝[1] 李勋华 杨瀚 王世成 张宗亮[1] Jiang Zaiqing;Wang Ke;Zhu Guanqun;Zhao Kai;Yin Xinbao;Li Xunhua;Yang Han;Wang Shicheng;Zhang Zongliang(Department of Urology,The Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong,China)

机构地区：[1]青岛大学附属医院泌尿外科,山东青岛266000

出　　处：《中国医学前沿杂志（电子版）》2024年第7期87-90,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨腹膜外途径保留女性生殖器官的膀胱全切原位回肠膀胱术手术技术并评估其治疗效果和肿瘤学结果。方法收集2019年2月至2022年12月期间就诊于青岛大学附属医院泌尿外科12例患者的基本资料、手术时间、出血量、性生活质量、排尿控制情况以及术后并发症的数据。定期随访患者的肿瘤和功能结局,术后使用女性性功能指数(Female Sexual Function Index,FSFI)评估性功能状况。结果回顾性分析12例平均年龄为51岁的接受保留生殖器官膀胱全切原位尿流改道术的女性患者。12例手术均顺利完成。平均手术时间(223.58±28.45)min,平均术中出血量(165.00±80.51)ml,术后病理切缘均显示阴性,无淋巴结转移。日间排尿可控制12例(100%),夜间排尿可控制10例(83.3%),患者术后平均FSFI评分为(21.9±1.2)分。结论对于经过筛选的女性膀胱癌患者,生殖器官保留技术是一种安全可行的手术策略。保存生殖器和血管神经束在肿瘤学上可能是安全的,临床疗效满意。Objective To investigate the surgical technique of total cystotomy with in situ ileal cystectomy for female genital organ preservation by the extraperitoneal route and to assess its therapeutic and oncologic outcomes.Methods Between February 2019 and December 2022,data were collected on patientsoperative time,bleeding,sexual quality of life,urinary control,and postoperative complications.Patients were regularly followed for oncologic and functional outcomes,and sexual function status was assessed postoperatively using the Female Sexual Function Index(FSFI).Results Twelve female patients with a mean age of 51 years who underwent total genitally preserved cystectomy with in situ urinary diversion were retrospectively analyzed.All 12 surgeries were successfully completed.The mean operative time was(223.58±28.45)min,the mean intraoperative bleeding was(165.00±80.51)ml,and all postoperative pathologic margins showed negative and no lymph node metastasis.The mean postoperative FSFI score was(21.9±1.2)in 12(100%)patients with daytime urinary control and 10(83.3%)patients with nocturnal urinary control.Conclusions Genital preservation technique is a safe and feasible surgical strategy for screened female bladder cancer patients.Preservation of genitalia and vascular nerve bundles may be oncologically safe with satisfactory clinical outcomes.Further rigorous prospective studies with more patients and long-term follow-up data are needed to assess oncologic and functional outcomes.

关 键 词：腹膜外途径 腹腔镜 生殖器官保留 膀胱全切 原位尿流改道 

分 类 号：R699.5[医药卫生—泌尿科学]