腹腔镜下经腹膜外入路膀胱癌根治术的初步体会

目的 评估腹腔镜下经腹膜外入路膀胱癌根治术的可行性及临床疗效.方法 选取2017年5月-2019年5月肌层浸润性膀胱癌患者16例,年龄54～78岁,平均69.4岁.开展腹腔镜下腹膜外入路膀胱癌根治术,术中经腹膜外膀胱切除及淋巴清扫,3例行输尿管皮肤造口术,1例行Studer原位回肠新膀胱术,其余12例行Bricker回...

Initial experience of laparoscopic extraperitoneal approach for radical resection of bladder cancer

Objective To evaluate the feasibility and clinical effect of laparoscopic radical resection of bladder cancer by extraperitoneal approach.Methods 16 cases of musculocutaneous invasive bladder cancer were selected from May 2017 to May 2019, aged 54 to 78 years, the average was 69.4 years old. Laparoscopic extraperitoneal approach for radical resection of bladder cancer was performed, extraperitoneal bladder resection and lymph node dissection was performed during operation, 3 cases underwent ureterocutaneostomy, 1 case underwent Studer orthotopic ileal neobladder, the remaining 12 cases underwent Bricker ileostomy, ileal channel or neobladder was put out of peritoneal cavity with complete closure of the peritoneum, complications and intestinal function recovery were observed after surgery.Results All the operations were completed successfully, no patients were converted to opening surgery or transperitoneal operation. Intraoperative blood loss was 120 ~ 360 mL, and the average was 190 mL. 3 cases of ureterocutaneostomy resumed diet on the first day after operation, and the other 13 cases resumed diet on average 4 days after operation, and the time of hospitalization after operation was 7 ~ 19 d, the average was 13.8 d. Follow up for 8 ~ 32 months showed no recurrence and metastasis, no intestinal obstruction occurred, 1 case had mild hydronephrosis and no progressive aggravation. All the patients had normal renal function.Conclusion Laparoscopic extraperitoneal radical cystectomy is safe and effective, and postoperative intestinal function recovery is faster, which is worthy of clinical promotion.