腹腔镜根治性膀胱切除+回肠原位新膀胱术疗效分析

目的:回顾分析腹腔镜下全膀胱切除+回肠原位新膀胱术的临床疗效与经验.方法:随访了2006年1月-2012年2月采用腹腔镜下根治性膀胱切除术+回肠原位新膀胱术治疗的87例患者,手术方法为腹腔镜下膀胱全切术+开放新膀胱构建及吻合,并对随访3年的临床数据进行总结分析.结果:大多数患者恢复良好,所有的新膀胱漏尿并发症均被有效处理;仅有1例患者因肠瘘行肠造口,3个月后行肠回纳;术后3年整体生存率为88.5％(77/87),无瘤生存率为92.2％ (71/77);整体控尿功能及肾功能保护方面取得良好效果.结论:腹腔镜下根治性膀胱全切+回肠原位新膀胱术,具有良好的控尿功能和较好的保肾功能,可以明显提高患者生活质量.

Oncological results of laparoscopic radical cystectomy with orthotopic ileal neobladder

Objective:To summarize the clinical curative effect and experience of orthotopic ileum bladder following radical cystectomy in the bladder cancer patients.Methods:January 2006 to February 2012,87 patients underwent radical cystectomy and orthotopic ileum bladder reconstruction,and summarize the 3 years clinical data of follow-up.Results:Most of the patients recovered well,all of the new bladder leakage complications were effective treated.Only one patient with major urinary leak required re-exploration with successful revision anastomosis.The 3-year survival rate after surgery was 88.5％ (77/87).The disease free survival proportion was 92.2％ (71/77).Effective daytime and nighttime urinary continence as well as renal function deterioration were great.Conclusion:Laparoscopic radical resection of bladder in situ ileum new bladder surgery has the good function of urinary continence and better protect renal function,significantly improving the patients quality of life.