腹腔镜下根治性全膀胱切除术100例总结

Laparoscopic radical cystectomy (report of 100 cases)

目的总结腹腔镜下全膀胱切除的经验。方法 2002年8月至2007年6月治疗浸润性膀胱癌100例,男82例,女18例,年龄32～81岁,无远处转移。腹腔镜下行盆腔淋巴结清扫,全膀胱切除,前列腺切除或子宫次全切除。经腹壁造口取出切除物,行乙状结肠去带原位新膀胱术。结果 100例腹腔镜下手术成功,手术时间80～270 min(平均150 min);开放原位新膀胱术160～300 min(平均210 min)。腹腔镜下操作出血量100～300 ml(平均180 ml);开放性原位新膀胱术出血量400～800 ml;术中、术后输浓缩红细胞0～400 ml(平均200 ml)。术后4～8 d恢复饮食,3周拔除输尿管支架管,4周拔除尿管。结论腹腔镜下根治性全膀胱切除术创伤小、出血少、术中操作精细、盆腔淋巴结清扫彻底、术后恢复快,可作为全膀胱切除手术的首选方法。

Objective To present our experience of 100 cases intraeorporeal laparoscopic radical cystectomy. Methods There were 82 males and 18 female 32-81 years old with organ confined, muscle invasive carcinoma of the bladder who underwent surgery from August 2002 to June 2007. Cystectomy and extended pelvic lymph node dissection underwent with intracorporeal laparoscopic technique exclusively. Removal of the mobilized specimens via enlarged incision. Construction of the detenial sigmoid neobladder. Results 100 cases were performed successfully. Laparoscpic operation time was 80 to 270 minutes and blood lose was 100 to 300 ml. Open operation time was 160 to 300 minutes and blood lose was 400 to 80Oral. Blood transfusion was 0 to 400 ml during and after operation. Oral intake was started on hospital day 4-8, ureteral stents were removed on week 3^th and the pouch catheter was removed on week 4^th. Conclusions The laparoscopic radical cystectomy with less incision and rapid recovery low complication and conversion rates, and high rates of patient satisfaction. May become the first choice surgical method for treating selected patients who had localized muscle invasive bladder cancer.