女性腹腔镜膀胱全切术+回肠新膀胱术24例临床分析

Clinical analysis of laparoscopic radical cystectomy with orthotopic ileal neobladder in 24 females

目的：探讨女性腹腔镜膀胱全切术＋回肠新膀胱术的临床应用并总结临床体会。方法：2011年1月～2015年12月,对24例女性膀胱癌患者行腹腔镜膀胱全切术＋回肠新膀胱术。随访10～46个月,平均26.4个月。观察患者围手术期及远期并发症以及患者排尿情况。结果：24例患者均成功完成手术,无严重并发症发生。平均手术时间（287±38）min,平均术中出血量（226±28）ml。术后3例出现轻度尿失禁,2个月后缓解。1例反复出现尿潴留。随访期内无肿瘤复发转移。结论：对于女性膀胱癌患者,腹腔镜膀胱全切术＋回肠新膀胱术并发症少,复发率低,有较好的储尿和排尿功能。

Objective：To investigate the feasibility and experience of laparoscopic radical cystectomy with orthotopic ileal neobladder in the female.Method：Between January 2011 and December 2015,a total of 24 female bladder cancer patients were treated with laparoscopic radical cystectomy with orthotopic ileal neobladder.Patients were followed up for 10 to 46months（mean,26.4）.Perioperative data and long-term complications and urinating condition were recorded.Result：All 24 operations were successful.No serious operation related complications occurred.Mean operating time was（287±38）min.Mean estimated blood loss was（226±28）ml.Three of them were found mild urinary incontinence after operation,and they recovered well two months later.Another one case suffered from repeated urinary retention.No tumor recurrence or metastasis occured during follow-up period.Conclusion：For female muscle-invasive bladder cancer patients,laparoscopic radical cystectomy with orthotopic ileal neobladder is a safe and effective surgery with less complications and satisfactory urinating function.