摘要
目的比较腹腔镜根治性膀胱切除术(LRC)与开放根治性膀胱切除术(ORC)的临床疗效及围术期并发症的发生情况。方法回顾性分析2012年1月至2016年12月解放军兰州总医院收治的行根治性膀胱切除术的139例膀胱癌患者的临床资料。其中,76例行LRC(LRC组),63例行ORC(ORC组),比较两组患者的病理结果及围术期并发症的发生情况等。结果本组139例患者均顺利完成手术,无围术期死亡。LRC组和ORC组的手术时间分别为(358.6±79.7)min和(316.6±86.4)min;术中出血量分别为(460.2±119.7)ml和(716.3±250.5)ml;输血例数分别为35例(46.1%)和44例(69.8%);术后24 h视觉模拟评分(VAS)分别为(5.2±0.8)分和(7.2±0.7)分;术后72 h全身炎症反应综合征(SIRS)发生率分别为51.3%(39/76)和71.4%(45/63);术后排气时间分别为(3.5±1.0)d和(4.4±1.5)d;术后住院时间分别为(18.1±5.2)d和(22.7±11.5)d;术后并发症的发生率分别为30.3%(23/76)和47.6%(30/63),两组比较,差异均有统计学意义(P<0.05)。结论与ORC比较,LRC安全有效,虽然手术时间较长,但能够显著减少术中出血量,减轻机体创伤及术后疼痛,缩短术后住院时间,降低手术相关并发症的发生率。
Objective To compare clinical outcome and perioperative complications between laparoscopic radical cystectomy（ LRC）and open radical cystectomy（ ORC）. Methods A retrospective study was performed on 139 cases of patients with bladder cancer who were admitted and underwent cystectomy from January 2012 to December 2016. Among the patients,76 cases who underwent LRC were in the LRC group,63 cases who underwent ORC were in the ORC group. The perioperative parameters,pathological results and surgeryrelated complications were compared between the two groups. Results All the 139 patients in this group were successfully completed the operation without perioperative death. The operative time in LRC group and ORC group was（ 358. 6 ± 79. 7） minutes versus（ 316. 6 ± 86. 4） minutes. The blood loss in LRC group and ORC group was（ 460. 2 ± 119. 7） ml versus（ 716. 3 ± 250. 5） ml. The blood transfusion in LRC group and ORC group were 35 cases（ 46. 1%） and 44 cases（ 69. 8%）,respectively. The visual analogue scale（ VAS） was（ 5. 2 ± 0. 8） in the LRC group and（ 7. 2 ± 0. 7） in the ORC group 24 hours after the surgery. The incidence of systemic inflammatory response syndrome（ SIRS） was 51. 3%（ 39/76） in the LRC group and 71. 4%（ 45/63） in the ORC group 72 hours after the surgery. The time to resume intestinal function was（ 3. 5 ± 1. 0） days versus（ 4. 4 ± 1. 5） days. The postoperative length of hospital stay was（ 18. 1 ± 5. 2） days versus（ 22. 7 ± 11. 5） days between the LRC group and ORC group. The incidence of complications in the LRC group and ORC group after operation was 30. 3%（ 23/76） and 47. 6%（ 30/63）,respectively（ P〈0. 05）. Conclusion LRC is safe and effective in the treatment of bladder cancer. It may bring less intraoperative blood loss,faster postoperative recovery and lower incidence of surgery-related complications than ORC,although with longer operative time.
出处
《临床军医杂志》
CAS
2017年第10期1031-1034,共4页
Clinical Journal of Medical Officers
关键词
膀胱癌
膀胱切除术
腹腔镜
开放手术
并发症
Bladder cancer
Cystectomy
Laparoscopes
Open surgery
Complications
