目的比较回肠膀胱术与原位回肠新膀胱尿流改道术后患者的健康相关生活质量（health related quality of life，HRQoL），为临床尿流改道术式的选择提供依据。方法选择2006年1月至2010年12月因膀胱癌行根治性膀胱全切加尿流改道术的患者...目的比较回肠膀胱术与原位回肠新膀胱尿流改道术后患者的健康相关生活质量（health related quality of life，HRQoL），为临床尿流改道术式的选择提供依据。方法选择2006年1月至2010年12月因膀胱癌行根治性膀胱全切加尿流改道术的患者130例，按术式分为回肠膀胱术组（IC）和原位回肠新膀胱术组（NB），采用问卷调查的方式完成膀胱癌术后随访量表（FACT—BL）。对FACT—BL量表各个领域（躯体状况、社会／家庭状况、精神状况，功能状况）的评分及总评分进行统计学比较分析。结果回收有效问卷94份，其中IC组50例，NB组44例。2组间男性例数、随访时间、≥T，例数差异无统计学意义，NB组患者手术年龄小于IC组。2组HRQoL评分：躯体状况分别为25．4±1．8、22．1±2．5，社会／家庭状况分别为20．3±2．8、16．3±4．2，膀胱癌特异性模块分别为29．5±2．8、20．2±3．3，FACT—BL量表总评分分别为109．5±6．9、99．3±7．9，2组差异均有统计学意义（P〈0．05）。结论原位回肠新膀胱术患者术后HRQoL高于回肠膀胱术患者。展开更多
目的对比机器人辅助腹腔镜、传统腹腔镜以及开放根治性全膀胱切除加回肠膀胱术的围手术期情况。方法回顾性分析2009年1月至2018年12月复旦大学附属中山医院泌尿外科单手术组开展的根治性全膀胱切除加回肠膀胱术248例,其中机器人辅助腹腔...目的对比机器人辅助腹腔镜、传统腹腔镜以及开放根治性全膀胱切除加回肠膀胱术的围手术期情况。方法回顾性分析2009年1月至2018年12月复旦大学附属中山医院泌尿外科单手术组开展的根治性全膀胱切除加回肠膀胱术248例,其中机器人辅助腹腔镜87例、传统腹腔镜32例、开放手术129例。比较3组性别、年龄、体重指数(body mass index,BMI)、合并慢性病、手术时间、术中输血率、术后输血率、入监护室率、术后红细胞下降值、术后血红蛋白下降值、术后白蛋白下降值、术后肌酐升高值、术后住院时间、住院总费用以及肠梗阻、感染等并发症发生率的差异。结果 248例手术均获成功,无中转其他手术方式。3组的年龄、性别、BMI、高血压病史、糖尿病病史、心脏病病史等方面比较,差异均无统计学意义。机器人手术组在手术时间、术后红细胞下降值、血红蛋白下降值、白蛋白下降值方面均显著小于另两组,在术后住院时间、术中输血率方面,机器人手术组也显著小于开放手术组(P<0.05);传统腹腔镜组在术后红细胞下降值、血红蛋白下降值方面显著小于开放手术组(P<0.05)。在住院总费用方面机器人手术组显著高于另两组(P<0.05)。在术后并发症方面,虽然机器人手术组发生率低于传统腹腔镜组和开放手术组,但差异无统计学意义。结论围手术期机器人辅助腹腔镜根治性全膀胱切除加回肠膀胱术较传统腹腔镜手术和开放手术具有手术时间短、创伤小和术后恢复快等优势,在经济可行的条件下,是治疗肌层浸润性膀胱癌的首选手术方法。展开更多
Background： Robot-assisted/laparoscopic intracorporeal ileal conduit （ICIC） has been reported in many experienced centers. Whether laparoscopic ICIC is superior to extracorporeal ileal conduit （ECIC） and whether ...Background： Robot-assisted/laparoscopic intracorporeal ileal conduit （ICIC） has been reported in many experienced centers. Whether laparoscopic ICIC is superior to extracorporeal ileal conduit （ECIC） and whether laparoscopic ICIC should be promoted is still controversial. The aim of the study was to compare surgical and early oncological outcomes between patients undergoing laparoscopic radical cystectomy （LRC） with ICIC and ECIC. Methods： From January 2011 to June 2016, a total of 45 patients with bladder cancer underwent LRC with ileal conduit at our department, of whom 20 patients underwent LRC with ECIC and 25 patients underwent LRC with ICIC. Data of each patient＇s characteristics, surgical outcomes, and short-term oncological outcomes were collected and analyzed. Results： LRC with ileal conduit was performed successfully on all 45 patients. There were no significant differences in patients＇ characteristics, mean total operative time, and mean estimated blood loss between the ICIC and ECIC groups. Median time of flatus and oral intake was shorter in the ICIC group compared with the ECIC group （3 vs. 5 days, P = 0.035; 4 vs. 5 days, P = 0.002）. The complications rates did not show significant difference between the two groups within the first 90 days postoperatively （P = 0.538）. Cancer staging showed 45% of patients in the ECIC group and 36% in the ICIC group had a pathologic stage of T3 or T4, and 50% of patients in the ECIC group and 44% in the ICIC group had a pathologic stage of N1 or N1＋. Kaplan-Meier analysis showed no significant difference in overall survival at 24 months （60% vs. 62%, P = 0.857） between the ECIC and ICIC groups. Conclusions： ICIC after LRC may be successful with the benefits of faster recovery time. No significant difference was found in complications and oncological outcomes between ICIC and ECIC. However, larger series with longer follow-up are needed to validate this procedure.展开更多
文摘目的比较回肠膀胱术与原位回肠新膀胱尿流改道术后患者的健康相关生活质量（health related quality of life，HRQoL），为临床尿流改道术式的选择提供依据。方法选择2006年1月至2010年12月因膀胱癌行根治性膀胱全切加尿流改道术的患者130例，按术式分为回肠膀胱术组（IC）和原位回肠新膀胱术组（NB），采用问卷调查的方式完成膀胱癌术后随访量表（FACT—BL）。对FACT—BL量表各个领域（躯体状况、社会／家庭状况、精神状况，功能状况）的评分及总评分进行统计学比较分析。结果回收有效问卷94份，其中IC组50例，NB组44例。2组间男性例数、随访时间、≥T，例数差异无统计学意义，NB组患者手术年龄小于IC组。2组HRQoL评分：躯体状况分别为25．4±1．8、22．1±2．5，社会／家庭状况分别为20．3±2．8、16．3±4．2，膀胱癌特异性模块分别为29．5±2．8、20．2±3．3，FACT—BL量表总评分分别为109．5±6．9、99．3±7．9，2组差异均有统计学意义（P〈0．05）。结论原位回肠新膀胱术患者术后HRQoL高于回肠膀胱术患者。
文摘目的对比机器人辅助腹腔镜、传统腹腔镜以及开放根治性全膀胱切除加回肠膀胱术的围手术期情况。方法回顾性分析2009年1月至2018年12月复旦大学附属中山医院泌尿外科单手术组开展的根治性全膀胱切除加回肠膀胱术248例,其中机器人辅助腹腔镜87例、传统腹腔镜32例、开放手术129例。比较3组性别、年龄、体重指数(body mass index,BMI)、合并慢性病、手术时间、术中输血率、术后输血率、入监护室率、术后红细胞下降值、术后血红蛋白下降值、术后白蛋白下降值、术后肌酐升高值、术后住院时间、住院总费用以及肠梗阻、感染等并发症发生率的差异。结果 248例手术均获成功,无中转其他手术方式。3组的年龄、性别、BMI、高血压病史、糖尿病病史、心脏病病史等方面比较,差异均无统计学意义。机器人手术组在手术时间、术后红细胞下降值、血红蛋白下降值、白蛋白下降值方面均显著小于另两组,在术后住院时间、术中输血率方面,机器人手术组也显著小于开放手术组(P<0.05);传统腹腔镜组在术后红细胞下降值、血红蛋白下降值方面显著小于开放手术组(P<0.05)。在住院总费用方面机器人手术组显著高于另两组(P<0.05)。在术后并发症方面,虽然机器人手术组发生率低于传统腹腔镜组和开放手术组,但差异无统计学意义。结论围手术期机器人辅助腹腔镜根治性全膀胱切除加回肠膀胱术较传统腹腔镜手术和开放手术具有手术时间短、创伤小和术后恢复快等优势,在经济可行的条件下,是治疗肌层浸润性膀胱癌的首选手术方法。
文摘Background： Robot-assisted/laparoscopic intracorporeal ileal conduit （ICIC） has been reported in many experienced centers. Whether laparoscopic ICIC is superior to extracorporeal ileal conduit （ECIC） and whether laparoscopic ICIC should be promoted is still controversial. The aim of the study was to compare surgical and early oncological outcomes between patients undergoing laparoscopic radical cystectomy （LRC） with ICIC and ECIC. Methods： From January 2011 to June 2016, a total of 45 patients with bladder cancer underwent LRC with ileal conduit at our department, of whom 20 patients underwent LRC with ECIC and 25 patients underwent LRC with ICIC. Data of each patient＇s characteristics, surgical outcomes, and short-term oncological outcomes were collected and analyzed. Results： LRC with ileal conduit was performed successfully on all 45 patients. There were no significant differences in patients＇ characteristics, mean total operative time, and mean estimated blood loss between the ICIC and ECIC groups. Median time of flatus and oral intake was shorter in the ICIC group compared with the ECIC group （3 vs. 5 days, P = 0.035; 4 vs. 5 days, P = 0.002）. The complications rates did not show significant difference between the two groups within the first 90 days postoperatively （P = 0.538）. Cancer staging showed 45% of patients in the ECIC group and 36% in the ICIC group had a pathologic stage of T3 or T4, and 50% of patients in the ECIC group and 44% in the ICIC group had a pathologic stage of N1 or N1＋. Kaplan-Meier analysis showed no significant difference in overall survival at 24 months （60% vs. 62%, P = 0.857） between the ECIC and ICIC groups. Conclusions： ICIC after LRC may be successful with the benefits of faster recovery time. No significant difference was found in complications and oncological outcomes between ICIC and ECIC. However, larger series with longer follow-up are needed to validate this procedure.
