腹腔镜与开放膀胱根治性切除-原位回肠新膀胱术的临床效果比较

目的比较腹腔镜与开放膀胱根治性切除-原位回肠新膀胱术治疗侵润性膀胱癌患者的临床效果。方法回顾性分析该院自2009年1月—2012年6月收治的36例侵润性膀胱癌患者的临床资料,按照不同术式分为腹腔镜组（n=16）和开放手术组（n=20）。比较两组患者围手术期情况、术后并发症和术后1年的膀胱功能。结果观察组手术时间明显长于对照组（366.8±42.5）min vs（308.4±38.2）min],而术中出血量（482.3±23.5）mL vs（1078.3±344.6）mL]和术后住院时间（22.8±3.7）d vs（28.6±4.9）d]均明显小于对照组,差异有统计学意义（P〈0.05）。观察组术后并发症明显少于对照组,差异有统计学意义（P〈0.05）;而两组患者术后1年的膀胱容量、膀胱内压和残余尿差异无统计学意义（P〉0.05）。结论腹腔镜下膀胱根治性切除术-原位回肠新膀胱术对机体损伤小、术后恢复快和并发症较少的优点,且术后膀胱功能与开放手术相当,是一种值得推广应用的术式。

Comparison of the Clinical Effect Between Laparoscopic and Open Radical Resection of Bladder In Situ Ileum New Bladder Surgery

Objective To compare the clinical effect of laparoscopic and open radical resection of bladder in situ ileum new bladder surgery for the treatment of patients with invasive bladder cancer. Methods The clinical data of 36 patients with invasive bladder cancer admitted in our hospital from January, 2009 to June, 2012 were retrospective analyzed. And they were divided into laparoscopic group（observation group, n=16） and open surgical group（control group, n=20） according to the different operation. The perioperative status and postoperative complications and bladder function 1 year after the operation were compared between the two groups. Results The operation time of the observation group was significantly longer than that of the control group （366.8± 42.5） min vs（308.4±38.2）min], while the intraoperatve blood loss （482.3±23.5） ml vs（1078.3±344.6）ml] and length of stay （22.8±3.7） d vs（28.6±4.9）d] were smaller than those of the control group, the differences were statistically significant（all P 0.05）. The postoperative complications of the observation group was obviously less than those of the control group, the difference was statistically significant（P〈0.05）; and the differences in bladder capacity, intravesical pressure and residual urine in bladder 1 year after the operation between the two groups were not statistically significant（all P〉0.05）. Conclusion Laparoscopic radical resection of bladder in situ ileum new bladder surgery has the advantages of causing minimal damage to the body, postoperative recover faster, fewer complications, and the postoperative bladder function is equivalent to that of the open operation, which is worthy of popularization and application.