摘要
目的 研究腹腔镜根治性膀胱癌切除术(LRC)后两种不同尿流改道方式的疗效,为临床选取不同尿流改道提供参考。方法 回顾性分析锦州医科大学附属第一医院2015年8月至2019年12月行LRC联合原位回肠新膀胱(IN)或输尿管皮肤造口(CU)的男性膀胱癌患者43例,根据不同尿流改道方式,分为IN组(21例)和CU组(22例),比较两组患者的术中情况、术后近期并发症(3个月内)及生活质量。结果 IN组的手术时间、胃肠道恢复时间及住院时间均长于CU组,出血量也多于CU组,差异均有统计学意义(P<0.001);两组的近期并发症发生率比较,差异无统计学意义(P>0.05);IN组的术后生活质量评分高于CU组,差异有统计学意义(P<0.05)。结论IN手术时间长、操作复杂,但接近于生理性排尿,术后的生活质量较高,而CU的手术时间较短、出血也少,适合不宜进行长时间手术的高龄患者,在临床应根据患者意愿及病情特点选择合适的尿流改道方式。
Objective To study the efficacy of two different urinary diversion methods after laparoscopic radical cystectomy(LRC),and to provide references for clinical selection of different urinary diversion methods.Methods A total of 43 male patients with bladder cancer who underwent LRC combined with orthotopic ileal neobladder(IN)or cutaneous ureterostomy(CU)in First Affiliated Hospital of Jinzhou Medical University from August 2015 to December 2019 were selected retrospectively.According to different urinary diversion methods,they were divided into the IN group(21 patients)and the CU group(22 patients).The intraoperative condition,recent postoperative complications(within 3 months)and quality of life were compared between the two groups.Results The operation time,gastrointestinal recovery time and hospitalization stay in the IN group were longer than those in the CU group,and the amount of bleeding in the IN group was more than that in the CU group,with statistically significant differences(P<0.001).There were no statistically significant difference in the incidence of recent complications between the two groups(P>0.05).The postoperative quality of life score in the IN group was higher than that in the CU group,with statistically significant difference(P<0.05).Conclusion The IN method has long operation time and complicated procedure,but it is close to physiological urination and the postoperative quality of life is higher.The CU method has shorter operation time and less amount of bleeding,which is preferred for elderly patients who are not suitable for long-term surgery.The clinical selection of urinary diversion methods should be based on the patient′s willingness and condition characteristics.
作者
李鹏飞
佟明
LI Pengfei;TONG Ming(First Ward of Urology Oncology,First Affiliated Hospital of Jinzhou Medical University,Jinzhou121000,China)
出处
《中国现代医生》
2022年第1期73-76,共4页
China Modern Doctor
关键词
膀胱癌根治性切除术
腹腔镜
尿流改道
原位回肠新膀胱
输尿管皮肤造口
Radical cystectomy for bladder cancer
Laparoscopy
Urinary diversion
Orthotopic ileal neobladder
Cutaneous ureterostomy
