摘要
目的比较腹腔镜与开放性膀胱根治性切除+原位回肠新膀胱术治疗肌层浸润性膀胱癌的临床效果。方法根据手术方式的不同将54例肌层浸润性膀胱癌患者分为腹腔镜手术组(31例)及开放手术组(23例),比较2组手术时间、术中出血量、胃肠功能恢复时间、住院时间、并发症情况、术后尿控率及术后3个月膀胱功能。结果腹腔镜手术组术中出血量和术后胃肠功能恢复时间均少/短于对照组(P均<0.05);2组术后住院时间及手术并发症发生率比较差异无统计学意义(P均>0.05);术后3个月,2组患者的膀胱容量、膀胱内压、最大尿流率及控尿率比较差异无统计学意义(P均>0.05)。结论腹腔镜膀胱根治性切除+原位回肠新膀胱术治疗肌层浸润性膀胱癌不会增加围手术期并发症风险,术后膀胱功能恢复情况与开放手术相似,且手术创伤更小、术中出血量更少、术后胃肠功能恢复时间更短。
Objective To compare the clinical efficacy between laparoscopic and open radical cystectomy combined with in situ ileal neobladder in the treatment of muscle-invasive bladder cancer. Methods Fifty-four patients with muscle-invasive bladder cancer were assigned into the laparoscopic( n = 31) and open radical cystectomy groups( n = 23). The operation time, intraoperative blood loss, gastrointestinal function recovery time, length of hospital stay, incidence of perioperative complications, postoperative urinary control rate and bladder function at postoperative 3 months were statistically compared between two groups. Results In the laparoscopic surgery group, the intraoperative blood loss and postoperative gastrointestinal function recovery time were less and shorter than those in the open surgery group( both P < 0.05). The length of hospital stay and the incidence of perioperative complications did not significantly differ between two groups( both P > 0.05). At postoperative 3 months, the bladder volume, intravesical pressure, maximum urinary flow rate and urinary control rate did not significantly differ between two groups( all P > 0.05). Conclusions Laparoscopic radical resection combined with in situ ileal neobladder does not increase the risk of intraoperative complications and yields similar postoperative bladder function recovery to open surgery. Compared with open surgery, laparoscopic surgery causes slighter surgical trauma, less intraoperative blood loss and faster postoperative recovery of gastrointestinal function.
作者
李茂章
周晓波
廖锦先
陈惠
Li Maozhang;Zhou Xiaobo;Liao Jinxian;Chen Hui(Department of Urology,Huizhou Municipal Central Hospital,Huizhou 516001,China)
出处
《新医学》
2019年第7期540-544,共5页
Journal of New Medicine
