膀胱癌腹腔镜根治性膀胱切除-尿流改道术的临床疗效

Clinical efficacy of laparoscopic radical resection of bladderurinary diersion for carcinoma of urinary bladder

目的：探讨膀胱癌腹腔镜根治性膀胱切除-尿流改道术的临床疗效。方法选择2011年1月-2013年6月在我院治疗的膀胱癌患者51例为研究对象。其中22例患者在腹腔镜下行根治性膀胱切除术为腹腔镜组，29例患者行开腹根治性膀胱切除术治疗为开腹组。比较两组患者术中及术后情况。结果腹腔镜组的手术时间显著长于开腹组（P＜0.01）；术中出血量显著少于开腹组（P＜0.01）；术后肠道功能恢复时间、术后下床活动时间、术后住院时间均显著短于开腹组（P＜0.01）。腹腔镜组术后并发症发生率显著小于开腹组（P＜0.05）。术后12个月随访，腹腔镜组新膀胱功能与开腹组比较差异无统计学意义（P＞0.05）。两组患者清扫淋巴结的阳性率、手术切缘、术后2年生存率比较差异无统计学意义（P＞0.05）。结论腹腔镜下根治性膀胱切除-尿流改道术治疗膀胱癌与开腹手术具有相似的临床疗效，但是其具有创伤小、恢复快等优点。

Objective To discuss the clinical efficacy of laparoscopic radical resection of bladder-urinary diersion for carcinoma of urinary bladder. Methods Fifty-one cases with carcinoma of urinary bladder from Jan 2011 to Jun 2013 were selected as subjects. Twenty- two cases of laparoscopic group were treated with laparoscopic radical resection, and 29 cases of open resection group were treated with open radical cystectomy. Intraoperative and postoperative conditions of two groups were compared. Results Operation time of laparoscopic group was longer than open resection group（P〈0.01）;Intraoperatve blood loss was less than open resection group（P〈0.01）;Postoperative recovery of intestinal function time,postoperative activity time, postoperative hospital stay were shorter than open resection group（P 〈 0.01）. Complications of laparoscopic group were less than open resection group（P 〈 0.05）. Followed up for 12 months, the new bladder function of two groups showed no significant difference（P〉0.05）. Clean lymph node positive rate, surgical margin, survival rate after two years of two groups showed no significant difference （P〉0.05）. Conclusion Laparoscopic radical resection of bladder-urinary diersion for carcinoma of urinary bladder shows similar clinical efficacy with laparotomy,and with the advantages of little trauma and quick recovery.