预先结扎髂内动脉分支在腹腔镜根治性膀胱切除术中的临床研究(附26例报告)

Clinical research of bilateral internal iliac artery pretreatment in laparoscopic radical cystectomy(Report of 26cases)

目的:探讨预先结扎髂内动脉分支在减少腹腔镜根治性膀胱切除术中出血的临床可行性。方法:2008年12月～2012年11月采用预先结扎双侧髂内动脉分支的方法对26例T2～T3期膀胱癌患者进行腹腔镜根治性膀胱切除术。结果:26例手术均获成功,根治手术时间160～210min,平均(187±20)min。术中出血60～350ml,平均(192±55)ml。随访2～12个月,所有患者均未出现臀部疼痛、臀肌萎缩以及间歇性跛行等臀肌缺血并发症。结论:腹腔镜根治性膀胱切除术中预先结扎壁支远端的髂内动脉干或分支,可有效减少术中出血,使手术的操作更精准,不会引起臀肌缺血的相关并发症。

To investigate the feasibility of bilateral internal ilica artery ligation before the laparoscopic radical cysteetomy to control intraoperatie bleeding. Method：During December 2008 to November 2012, 26 T2T3 invasive bladder cancer patients received the bilateral internal iliac artery ligation before the laparoseopic radical cystectorny. Result：Twenty-six cases were successfully operated with the laparoscopie radical cystectomy, the laparoscopic operative time160-210 （mean 187±20） rain. the blood loss 60-350 （192±55） ml. Based on the 2-12 months follow up results, all patients did not appear buttocks pain, gluteal muscle atrophy and intermittent claudi cation etc. Conelusion：Bilateral internal iliea artery ligation before the laparoscopic radical eystectomy can reduce blood loss, make surgery more accurate. And ligation of the internal ilica artery does not lead to complications related to gluteal muscles isehemia.