腹腔镜下膀胱全切术(附7例报告)

目的 探讨腹腔镜下膀胱全切除术的手术方法和临床效果。方法 浸润性膀胱癌患者7例，年龄53-74岁，平均61岁，均为男性，无远处转移，采用5个套管针，腹腔镜下行膀胱全切术，前列腺切除，下腹正中作7cm切口，取出切除的膀胱前列腺，常规行回肠膀胱术。结果 手术时间平均9．2h，出血量平均为264ml，所有病例均未输血，术后血红蛋白正常。术后2～10个月随访，肾功能正常，IVU检查未见输尿管吻合口狭窄或反流。结论 腹腔镜下膀胱全切术创伤小，出血少，恢复快，是全膀胱切除术一种具有临床应用前景的治疗方法。

Laparoscopic radical cystectomy. A report of seven cases

Objective To report the initial experience and results of the laparoscopic radical cystectomy (LRC) with ileal conduit. Methods Seven male patients with invasive bladder carcinoma confined to the organ underwent LRC with ileal conduit. The mean age was 61 years (range, 53 to 74 years). The procedure included radical cystectomy with prostatectomy. A 7 cm suprapubic incision was made to remove the organs. Ileal conduit was done routinely. Results Operating time was 7 to 10 hours (median 9.2), and blood loss was 200 to 400 ml (median 264). None of 7 patients needed blood transfusion. 2 to 10 months after surgery, intravenous urography showed no evidence of ureteral reflux or ureteral obstruction. Conclusions With the improvement in the surgical technique, laparoscopic radical cystectomy with small incision, resulting in rapid recovery, may become an alternative method for patients with localized bladder cancer with invasion to muscular layer.