摘要
【目的】对比分析腹膜外与经腹腔开放性根治性膀胱切除回肠膀胱术的临床应用效果。【方法】回顾性分析83例肌层浸润性膀胱癌患者的临床资料。其中45例为经腹膜外入路行根治性膀胱切除回肠膀胱术(腹膜外组),38例为经腹腔入路(经腹腔组)。【结果】腹膜外组平均手术时间240 min,平均出血量300 mL,术后肠道排气时间48.6 h,离床下地时间4.5d,术后住院时间12.5 d,均明显低于经腹腔组,差异均有统计学意义(P<0.05)。两组患者生存率、复发率和术后并发症发生率相近,远期疗效无明显差异(P>0.05)。【结论】根治性膀胱切除回肠膀胱术中采用经腹膜外入路较经腹腔入路出血少、腹腔干扰少、恢复快,尤其适用于临床分期T2期以下的膀胱肿瘤,是治疗浸润性膀胱癌的有效方法。
[Objective] To investigate the clinical effects of extra-peritoneal versus trans-peritoneal open radical cystectomy.[Methods] The clinical data of 83 patients with muscle invasive bladder cancer was analyzed retrospectively in our hospital from June 2001 to December 201 1.Forty-five patients underwent extra-peritoneal radical cystectomy with ileal conduit.The remaining 38 were submitted to the trans-peritoneal technique.[Results] Patients in extra-peritoneal group had shorter operating time （240 min）,less average blood loss （300 mL）,shorter anal exsufflation time （48.6 h）,shorter out of bed activity time （4.5 d） and shorter postoperative stay （12.5 d） compared to the patients in trans-peritoneal group （P 〈 0.05）.The two techniques did not differ with regard to the survival rate,recurrence rate,incidence of postoperative complications and long-term effect （P 〉 0.05）.[Conclusion] Compared to trans-peritoneal approach,the extra-peritoneal radical cystectomy is associated with less intraoperative average blood loss,small interference of abdominal cavity and quicker recovery.It is an effective treatment for muscle invasive bladder cancer,especially for the bladder cancer under stage T2.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2013年第3期438-441,共4页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省科技计划项目(2010B3160073)
关键词
肌层浸润性膀胱癌
根治性膀胱切除
回肠膀胱
经腹膜外入路
经腹腔入路
muscle invasive bladder tumor
radical cystectomy
ileal conduit
extraperitoneal approach
transperitonealapproach
