腹腔镜膀胱憩室切除术的临床应用

Clinical Value of Laparoscopic Resection of Bladder Diverticulum

目的探讨腹腔镜膀胱憩室切除术的临床应用价值。方法术前憩室同侧的输尿管内插入支架管作为标志以防损伤,保留导尿管。经腹腔或腹膜外途径行憩室切除术。先将膀胱充盈,分离憩室使其和周围膀胱充分显露,准确观察憩室颈口,放出膀胱内液体,将憩室切除。用2～0可吸收线连续锁边加间断缝合膀胱壁两层。同期处理其他疾病。结果本组患者手术均成功,围手术期无并发症。手术时间90～120min,术中出血20～40ml,术后1～2d拔除引流管,7天后行膀胱造影无憩室影像,切口愈合好,拔出导尿管,恢复正常排尿。随访时间6～38个月。无复发,排尿正常。结论通过本组患者的疗效观察,我们认为腹腔镜膀胱憩室切除术的临床应用是安全、可行的,具有创伤小、恢复快、并发症少等优点。可以同时行其他手术,一次完成膀胱憩室和其他疾病的治疗,具有临床应用价值。

Objective To assess the clinical value of laparoscopic extraperitoneal bladder diverticulectomy. Methods Inserted stent tube in the diverticulum ipsilateral ureter before operation was to prevent injury, retention catheter, diverticulectomies was performed through abdominal cavity or extraperitoneal. First fulling the bladder, Separating diverticulum to make itself and bladder fully dis- played, accurately observing diverticulum neck, releasing the liquid inside the bladder, removing the diverticulum, then two walls of urinary bladder were sutured by the way of successive chain shaped and discontinuity sutures with 2 -0 absorbable thread. And other diseases were simuhaneously treated. Results The operation of this group patients were success, and no complications during perioperative period. Operation time was 90 - 120min and intraoperative bleeding was 20 - 40ml, drainage tube was removed after I - 2d, bladder diverticulum was no contrast imaging after 7 days. The skin healed naturally, patients had a smooth emiction when＇ the catheter was removed, Follow - up 6 - 38 monthes, no recurrence and normal micturition. Conclusion Through the observation of curative effect of the group of patients, we consider that laparoscopic resection of the bladder diverticulum clinical applica- tion is safe and feasible, it has the merits of small wound, early recovery and less complication. At the same time, other operations can be carried out, bladder diverticulum and other diseases were treated in one time, which has clinical application value.