摘要
近年来，根治性膀胱切除术及尿流改道的方法不断优化和进步，手术安全性和疗效不断提高。从开放到腹腔镜到机器人，外科技术在不断进步，但目前尚无法互相取代。随着器械的发展，腹腔镜下根治性膀胱切除术／机器人辅助腹腔镜根治性膀胱切除术可进一步改善围手术期效果，基本可以复制开放手术的原则，围手术期肿瘤指标不劣于开放手术。机器人辅助腹腔镜根治性膀胱切除术在盆腔淋巴结清扫方面似乎更有优势，远期肿瘤效果3种技术相近，对于晚期肿瘤开放手术疗效似乎更好。体外构建储尿囊目前仍然是主流，体内构建储尿囊很可能是未来的方向。腹腔镜手术目前仍然是最适合我国国情的微创根治性膀胱切除术的手段。
In recent years, the techniques of radical cystectomy and urinary diversion are continually improving , the surgical safety and efficacy are continually increasing. From open to laparoscopic to robotic, surgical techniques are progressing, but it is not yet possible to replace each other. With the development of equipment, laparoscopic radical cystectomy （LRC） and robotic-assisted laparoscopic radical cystectomy （RARC）can further improve the perioperative efficacy, the basic principles of open surgery can be copied, their perioperative oncologic outcomes are not inferior to open surgery. RALRC seems to have more advantages in petrie lymph node dissection, tong-term onco[ogie outcomes of the three techniques are similar, and open surgery seems to have more advantages in advanced tumors. Intracorporeal construction of the urinary diversion is still the mainstream, extracorporeal is likely to be the future direction. Laparoscopy is still the most suitable minimally invasive technique of radical cystectomy according to our national conditions.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2017年第8期564-567,共4页
Chinese Journal of Urology
