腹腔镜与开放手术行根治性膀胱切除回肠膀胱术的比较研究

Comparison of laparoscopic and open radical cystectomy with ileal conduit diversion in patients with urinary bladder cancer

目的 通过与传统开放根治性膀胱切除回肠膀胱术比较,评价腹腔镜根治性膀胱切除回肠膀胱术治疗膀胱癌的临床价值.方法 回顾分析腹腔镜根治性膀胱切除回肠膀胱术32例（A组）及开放性根治性膀胱切除回肠膀胱术35例（B组）的临床资料,比较两种术式的围术期情况、术后并发症、新膀胱功能、肿瘤治疗效果.结果 A组平均术中出血量、术后肠功能恢复时间、术后下床活动时间、术后住院时间均少于 B组（P＜0.05 或0.01）,术后并发症发生率低于B组（P＜0.05 ）;而两组的手术时间、新膀胱容量、膀胱内压的差异均无统计学意义（均P ＞0.05）.结论 腹腔镜下根治性膀胱切除回肠膀胱术治疗膀胱癌是一种安全有效的膀胱全切除尿流改道术式.

Objective TO compare the efficacy and safety of laparoscopic and open radical cystectomy with ileal conduit diversion. Methods The clinical data of 32 cases receiving laparoscpic radical cystectomy with ileal conduit diversion （group A） and 35 cases receiving open surgery （group B） from May 2005 to Jul 2011 were retrospectively analyzed. The perioperative parameters, postoperative complications, the function of ileal neobladder and tumor control were compared between two groups. Results The indicators of estimated blood loss, recovery of intestinal function, ambulation and the length of hospital stay and postoperative complication rate in group A were better than those in group B（P〈0.05 or 0.01 ）. There were no significant dif- ferences in operation time, the volume and pressure of neobladder between two groups （P 〉0.05）. Conclusion Laparoscopic radical cystectomy with ileal conduit diversion is a safe and effective urinary diversion method for bladder neoplasms.