摘要
目的对比腹腔镜下膀胱癌根治和开放手术膀胱癌根治的临床效果。方法将2011年1月~2015年1月行腹腔镜膀胱癌根治术及回肠膀胱术41例作为腹腔镜组;开放膀胱癌根治术及回肠膀胱术56例作为开放手术组;比较两组手术时间、术中出血量、淋巴清扫个数、淋巴结阳性率、术后肠功能恢复时间,并进行统计分析。结果腹腔镜组除1例中转开放手术外,均在腹腔镜下完成。手术时间（364±53）min,术中出血量（220±110）ml,平均每例患者淋巴结清扫个数为16个,淋巴结阳性率15%,手术切缘阴性,术后肠功能恢复时间（4.6±0.5）天,2例不全性肠梗阻、经保守治疗后治愈,无肠漏及尿瘘,随访10~72月,1例尿道肿瘤复发,2例左肾积水。与开放手术组相比,腹腔镜手术组在出血量、术后肠功能恢复、下床活动、住院天数方面具有明显优势,腹腔镜手术更为耗时,术后并发症与开放手术相当。结论腹腔镜膀胱癌根治术与开放手术相比,具有创伤小,术后恢复快,并发症少等优点,是治疗膀胱癌安全有效的方法。
Objective To explore the clinical effect of laparoscopic radical cystectomy patients with bladder carcinoma.Methods 41 patients with bladder carcinoma underwent laparoscopic radical cystectomy and Bricker operation,and56 cases underwent open surgery during 2011-2015 year in our hospital.Results The other than surgery were operated in laparoscopic operation,except only 1case turned open surgery.The operative time was 364±53min.The intraoperative blood loss volume was 220±110ml ml.The average lymph node dissection number was 16.The lymph node positive rate of was 15%.The resection margin was negative.The intestinal function recovery time was about 2to 3days.2cases of incomplete intestinal obstruction were cured through conservative treatment.There were no intestinal fistula and urinary fistula.Followed-up for 10-72 month,1out of 41 had urethral tumor recurrence,2cases had left hydronphertion.Comparing with open surgery,laparoscopy surgery had advantage in blood loss,postoperative intestinal function recovery,hospital stay,laparoscopic surgery were more time-consuming.The postoperative complications was similar with open surgery.Conclusion Laparoscopic radical cystectomy,which has the advantages of less trauma,less postoperative recovery time,less complications and so on,is a safe and effective method to treat bladder carcinoma.
出处
《西部医学》
2016年第7期983-986,共4页
Medical Journal of West China
基金
四川省科技厅支撑计划项目(2015SZ0230)
四川省人事厅-学术带头人培育基金(川财社[2014]120号)
关键词
腹腔镜
膀胱癌
膀胱癌根治术
Laparoscopy
Bladder Carcinoma
Bladder cystectomy
