腹腔镜根治性膀胱切除术10例初步报告

Laparoscopic radical cystectomy with report of 10 cases

目的总结腹腔镜根治性膀胱切除术的临床效果。方法2007年6月～2008年10月,10例浸润性膀胱癌患者行腹腔镜根治性切除术,男9例,女1例,平均年龄为65.8岁;回肠新膀胱术9例,Bricker术1例。结果手术全部成功,平均手术时间6.5h(5.5～11h),术中平均出血量210ml(150～400ml)。术后3～4d恢复肠蠕动。1例出现术后尿漏,引流6d后停止。未出现感染、肠粘连和出血等并发症。平均随访4个月,未见肿瘤复发或转移。术后排尿基本正常。结论腹腔镜根治性膀胱切除术创伤小,出血少,恢复快,是一种安全、有效的治疗方法。

Objective To introduce our initial experience of 10 cases of laparoseopie radical cystectomy （LRC）.Methods From June 2006 to October 2008, 10 patients with invasive bladder cancer were treated with LRC, consisting of 9 males and 1 female with mean age of 65.8 years.Orthotopic ileal neobladder were applied in 9 cases and ileal conduit diversion was done in 1 case. Results The operations were performed successfully. The mean operative time was 6.5h （5.5 to 1 lh）, and the mean estimated intraoperative blood loss was 210ml （150 to 400ml）.Reeovery of bowel movement occurred 3-4 clays after surgery.No severe infection intestinal obstruction clue to adhesion and hemorrhage and other major complications occurred except for one ease of urinary leakage which ceased spontaneously after 6 days drain.Tumor recurrence was not found during mean 5 months followup,and all urinated normally.Conclusion LRC is a safe, effective and feasible but technically challenging alternative for invasive bladder cancer.