腹腔镜与开放手术行根治性膀胱切除的对照研究

Comparison of laparoscopic and open radical cystectomy

目的:探讨腹腔镜下根治性膀胱切除术的可行性和效果。方法:选择我院2010年至2012年行腹腔镜根治性膀胱切除回肠膀胱的病人,对照选自同一医院同一时期的泌尿外科开放行根治性膀胱切除回肠带膀胱病人,按年龄、性别、疾病及手术方法进行1∶2匹配,回顾性分析病历。结果:腹腔镜组32例及开放组64例。腹腔镜组平均术中出血量、术后肠功能恢复时间、术后住院时间均少于开放组(P<0.05)。两组的手术时间腹腔镜组大于开放组(P<0.05)。术后并发症发生率差异无统计学意义(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及尿流改道方法,但是在初期开展腹腔镜手术可能需花费时间更长。

Objective：To compare the efficacy and safety of laparoscopic and open radical cystectomy.Methods：The clinical data of 32 cases receiving laparoscpic radical cystectomy with ileal conduit diversion and 64 cases which was selected and matched by age,gender,disease and operation technique receiving open surgery from Decmber 2010 to Decmber 2012 were retrospectively analyzed.Results：The estimated blood loss,recovery of intestinal function,and the length of hospital stay in laparoscopic group were better than those in open group （P ＜ 0.05）.There were significant differences in postoperative complication rate,the operation time in open group was short than laparoscopic group （P ＜ 0.05）.Conclusion：Laparoscopic radical cystectomy with ileal conduit diversion is a safe and effective urinary diversion method for bladder carcinoma,but it need more time in the initial stage of laparoscpic operation.