摘要
目的:对单中心腹腔镜下与开放根治性膀胱切除加回肠膀胱术的术后早期并发症进行比较。方法:收集行根治性膀胱切除加回肠膀胱术且临床资料完整的患者共130例,其中80例行开放手术,50例行腹腔镜手术,比较两组之间手术时间、术中估计失血量、术后住院天数、手术早期并发症情况的差异。结果:开放手术组手术时间平均(307.4±67.3)min,腹腔镜手术组手术时间为平均(356.8±67.0)min,两组间差异有显著统计学意义(P<0.01)。开放手术组估计失血量平均(590.6±320.5)ml,腹腔镜手术组估计失血量量平均(336.0±217.1)ml,两组间差异有显著统计学意义(P<0.01)。开放手术组术后住院时间12.25~24.75 d,平均17 d,腹腔镜手术组住院时间11~16 d,平均13 d,两组间的差异有显著统计学意义(P<0.01)。开放手术组术后早期并发症率为43.7%,腹腔镜手术组术后早期并发症率为38.0%,开放手术组发热、切口相关并发症明显多于腹腔镜手术组,差异有统计学意义(P<0.05)。ClavienDindo分级Ⅲ~Ⅳ级的严重并发症两组之间差异无统计学意义(P>0.05)。结论:腹腔镜膀胱癌根治切除相比开放手术可以有效减少手术中出血、缩短住院天数、并有效降低低级别并发症的发生率。
Objective To analyze the early postoperative complications of laparoscopic and open radical cystectomy using a standard grading system. Method The clinical data of 130 cases who underwent radical cystectomy and ileal conduit in our insti-tute were reviewed. 80 cases underwent laparoscopic surgery. 50 underwent open surgery. Operation time,estimated blood loss, post - operative hospital stay and complications within 90 days were collected. Complications were categorized with the Clavien - Dindo garding system. Results The average operation time was longer in the laparoscopic group than in the open group [ （ 307. 4 ±67. 3） min vs （356. 8 ±67. 0） min,P 〈 0. 01 ]. The mean estimated blood loss [ （590. 6 ± 320. 5 ） ml vs （ 336. 0 ± 217. 1 ） ml〈0. 01 ] and post - op erative hospital stay length （13 d vs 17 d,P 〈0. 01） was significantly less in the laparoscopic group than in the open group. The overall complication rate was higher in open group than in laparoscopic group （43.1% vs 38. 0% ,P =0. 517）. Fever and incision complication rate were significantly higher in open group than in laparoscopic group （P 〈0. 05）. However,there was no significant difference observed in severe complications of Clavien - Dindo level IH - V between open group and laparoscopic group （ P 〉 0. 05 ）. Conclusion Laparoscopic radical cystectomy and ileal conduit can help reducing esti-mated blood loss,post operative hospital stay and mild complication rate.
出处
《吉林医学》
CAS
2017年第7期1225-1227,共3页
Jilin Medical Journal
