腹腔镜下根治性全膀胱切除术与开放手术近期疗效比较

Radical cystectomy for bladder cancer:short-time outcome of laparoscopy versus open surgery

目的比较腹腔镜下根治性全膀胱切除术与传统开放根治性全膀胱切除术的近期疗效。方法对2007年11月-2009年8月该院施行的35例腹腔镜下根治性全膀胱切除术及36例传统开放性手术的围手术期情况、术后恢复及并发症发生情况进行比较分析。结果腹腔镜组的平均手术时间为319.6min,开放组为313.9min（P〉0.05）。腹腔镜组术中出血量、术中输血量、肛门排气时间、恢复进食时间、术后平均住院时间及术后并发症发生率分别为637.1mL、405.7mL、4.0d、5.3d、25.5d及28.6%,而开放组分别为922.2mL、655.6mL、4.6d、6.1d、36.4d及55.6%（P〈0.05）。结论腹腔镜下根治性全膀胱切除术安全可行,具有出血少、恢复快、并发症少和住院时间短的优点,近期疗效满意。

【Objective】 To compare the short-time outcome of laparoscopic radical cystectomy（LRC） versus open radical cystectomy（ORC）.【Methods】 This study was conducted between November 2007 and August 2009 in 71 patients who underwent radical cystectomy for bladder cancer.A total of 35 cystectomies were performed laparoscopically and 36 by open surgery.The parameters were analyzed included perioperative data,postoperative recovery and complications.【Results】 The mean operating time was 319.6 min in LRC group while 313.9 min in ORC group（P 0.05）.The mean blood lost,intraoperative transfusions,return to normal bowel function,resumption of oral intake,the time of mean hospital stay and the incidence of complications were 637.1 mL,405.7 mL,4.0 d,5.3 d,25.5 d,28.6% in LRC group while 922.2 mL,655.6 mL,4.6 d,6.1 d,36.4 d,55.6% in ORC group（All P 0.05）,respectively.【Conclusions】 LRC is secure and effective for bladder cancer,and it is with lower blood lost during operation,earlier return of bowel function,lower complications and shorter hospitalization,and can provide better short-term outcome.