摘要
目的观察腹腔镜下根治性膀胱切除乙状结肠原位新膀胱术治疗肌层浸润性尿路上皮膀胱癌的效果。方法21例肌层浸润性尿路上皮膀胱癌病例，先行腹腔镜下根治性膀胱切除并盆腔淋巴结清扫，然后下腹部小切口行乙状结肠原位新膀胱术，术后对其并发症及疗效进行分析。结果21例患者手术均获得成功，手术时间（245±125）min，术中出血（98±45）mL。术后均进行随访3-24个月，平均12个月，双侧轻度肾积水6例（28．6％），单侧肾积水1例（0．5％），储尿囊容量为（548．8±221．6）mL，新膀胱储尿期压力（2．26±0．24）kPa，新膀胱排尿期压力（6．18±0．29）kPa，残余尿量（87±52）mL，最大尿流率（83．2±5．6）mL/s，昼尿控率90．4％，夜尿控率76．1％，1例尿道狭窄，行尿道扩张后好转，无明显的电解质及酸碱平衡紊乱。结论腹腔镜下根治性膀胱切除乙状结肠原位新膀胱术临床效果可靠，无严重手术并发症，患者生活质量较高，容易被患者所接受，临床可以推广应用。
Objective To investigate the clinical therapeutic effect of sigmoid neobladder after laparoscopic radical cystectomy in the treatment of invasive bladder cancer. Methods 21 patients with invasive bladder cancer accepted sigmoid neobladder after laparoscopic radical cystectomy and pelvic lymphadenectomy. The postoperative complications and clinical therapeutic effect were analyzed. Results All surgeries were completed successfully. The operation time was （ 245 ± 125 ） min, blood lost was （ 98 ± 45 ） mL. All the 21 patients were followed up for 3 - 24 months, mean of 12 months. Both side mild hydronephrosis in 6 cases （28.6%） and unilateral hydronephrosis in 1 case（0.5% ）. Average bladder reservoir was （548.8 ± 221.6） mL, the maximum bladder pressure during the new bladder urine storage period was （2.26 ± 0.24 ） kPa, the maximum bladder pressure during voiding period was （6.18 ±0.29）kPa, volume of residual urine was （87 ± 52）mL. The mean maximum uroflow rate was （83.2 ± 5.6） mL/s. The continence of micturition was 90.4% in day - time and 76.1% in night - time. 1 case had urethral stricture and got better after the urethral dilatation. Conclusion The sigmoid neobladder after laparoscopic radical cystectomy has more reliable results,without serious postoperative complications and patients with high quality of life after operation. This operation may be applied in clinical practice.
出处
《中国基层医药》
CAS
2018年第5期647-649,共3页
Chinese Journal of Primary Medicine and Pharmacy
