腹腔镜膀胱根治性切除术围手术期并发症分析

目的探讨腹腔镜下膀胱根治性切除术围手术期并发症发生情况。方法统计本院2016年12月至2018年12月104例膀胱癌患者行腹腔镜下根治性膀胱切除术(LRC)围手术期的并发症以及手术时间、术中出血量、术后住院时间等情况。围手术期并发症定义为手术30 d内发生的并发症。结果平均手术时间327 min,平均出血量478 mL,接受输血者16例(15.4%),平均输血量415 mL。术后平均住院时间17.9 d。尿流改道方式上,Bricker回肠膀胱术68例,输尿管皮肤造口术36例。围手术期并发症发生率47.1%(49例),包括肠梗阻、尿路感染、肺炎、下肢静脉血栓、肺栓塞等。结论腹腔镜下膀胱根治性切除术仍有较高的并发症发生率,常见并发症为肠梗阻,尿路感染等,术前应积极治疗基础疾病,术中严格操作,术后采取相应预防措施以防止出现严重并发症。并根据患者情况选择合适的手术方案。

Analysis of perioperative complications of laparoscopic radical cystectomy for bladder cancer

Objective To evaluate operation process and perioperative complications of patients who underwent laparoscopic radical cystectomy(LRC).Methods The clinical data of 104 cases of LRC from December 2016 to December 2018 were reviewed retrospectively.Perioperative complications,the operative time,blood loss and postoperative hospital stay were analyzed.Perioperative complications were defined as complications occurring within 30 days of surgery.Results The mean operation time was 327 minutes,the mean blood loss was 478 mL,The number of patients with transfusin was 16 cases(15.4%),the mean transfusion volume was 415 mL,and the average postoperative hospital stay was 17.9 d.For urinary diversion,ileal conduits were constructed in 68 patients,ureterocutaneostomies in 36 patients.A total of 49 patients(47.1%)developed at least one perioperative complication,which included ileus,urinary tract infections,deep venous thrombosis of the lower limbs,pneumonia,etc.Conclusions Morbidity of perioperative complications following LRC is still high.The most frequent complications are ileus and urinary tract infections.Preventive measures should be taken to prevent serious complications.And we should choose an appropriate surgical procedure according to the patient's condition.