完全腹腔镜下根治性膀胱切除回肠膀胱术的疗效观察

目的:探讨完全腹腔镜下根治性膀胱切除回肠膀胱术的可行性,并总结手术技巧。方法:回顾性分析3例膀胱肿瘤患者行完全腹腔镜下根治性膀胱切除回肠膀胱术的临床资料。结果:3例手术均获成功,手术时间分别为480、450和420min,出血量分别为400、750和330ml,肠道功能恢复时间分别为56、62和78h,引流管于术后8~15天拔除。术后住院时间分别为17、13和15d,术后4周拔除单J管。术中、术后均无并发症,无尿瘘、肠瘘或肠梗阻等发生。随访3~6个月,肾功能正常,无肾积水,未见肿瘤复发、转移等。结论:完全腹腔镜下根治性膀胱切除回肠膀胱术安全可行,但手术难度大,需熟练掌握腹腔镜操作技术后方可开展。

Pure laparoscopic radical cystectomy with complete intracorporeal ileal conduit diversion

Objective：To evaluate the feasibility and summarize our technique of pure laparoscopic radical cys- teetomy with complete intracorporeal ileal conduit diversion. Method：We retrospectively analyzed the data of three patients with bladder tumor undergone pure laparoscopic radical eystectomy with complete intracorporeal ileal con- duit diversion. Result：The operations were performed successfully in three patients. The operation time was 480, 450 and 420 min respectively, and the blood loss was 400, 750 and 330ml, respectively. Bowel function was re- sumed at 56, 62 and 78 hours postoperatively, and the suction drains were removed at 8-15 days postoperatively. Postoperative hospital stay of these three cases was 17, 13 and 15 days respectively. The single J-stent was re- moved at/our weeks postoperatively. No intraoperative or postoperative complications including bowel obstruc- tion, urine or intestinal leakage occurred. Over a follow-up period of 3-6 months, all the patients had normal renal function, no hydronephrosis, recurrence or metastatic diseases were found. Conclusion： Pure laparoscopic radical eystectomy with complete intracorporeal ileal conduit diversion is a safe and feasible technique, which should be performed by an experienced surgeon.