摘要
目的:介绍腹腔镜下全膀胱切除术的初步体会。方法:2006年1月至2008年12月治疗浸润性膀胱癌12例,男10例,女2例,年龄48~69岁,无远处转移。腹腔镜下行全膀胱切除、前列腺切除或子宫次全切。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:12例手术成功,腹腔镜下手术时间120~280min(平均180min);开放原位新膀胱术190~300min(平均240min)。腹腔镜下操作出血量400~1000ml(平均600m1);术中、术后输浓缩红细胞400~600ml(平均500m)。12例随访6~36个月,平均15个月。白天可控排尿10例(83.3%)轻度尿失禁2例(16.7%)。新膀胱容量180~320ml(平均270m1),尿间隔时间45~120min(平均80min)。1例勃起功能障碍(术前4例有勃起功能)。患者血Cr和Bun正常,未出现酸中毒。结论:腹腔镜下全膀胱切除术是可行和值得临床推广应用。
Objective :To introduce the preliminary experience in laparoscopic total cystectomy. Method:From January 2006 to December 2008 ,We treated a total of 12 cases of distant metastasis -free invasive bladder cancer. There were 10 male and 2 female, 48 - 69 years old. These patients were performed prostatectomy or hysterectomy depending on the circumstances. Patients were performed laparoscopic radical cystectomy with reconstruction of bladder with sigmold . Result: All operations were successfully completed with the operation time of 120 -280min (mean 180 min), with open orthotopic neobladder time 190 -300min ( mean 240 min ), the blood loss 400 - 1000ml ( mean 600ml). Intraoperative and postoperative, transfusion of red blood cell concentrates 400 - 600ml (mean 500ml). 12 cases were followed up for 6 -36 months( mean 15 ). 10 cases voided smoothly during the day (83.3% ) , and 2 cases became mild incontinence ( 16. 7% ). The new bladder capacity was 180 - 320ml (mean 270ml) , the time between urine was 45 - 120min ( mean 80min). 1 case was erectile dysfunction after surgery ( Erectile function of 4 cases were normal ). All patients Cr and Bun was normal. Acidosis does not appear. Conclusion:Laparoscopic radical cystectomy is feasible and worthy of clinical application
出处
《河北医学》
CAS
2009年第11期1293-1295,共3页
Hebei Medicine
关键词
腹腔镜
膀胱癌
全膀胱切除
尿流改道
Laparoscopy
Bladder neoplasms
Cysteetomy
Urinary diversion