腹腔镜根治性膀胱切除+回肠原位新膀胱术疗效分析

Oncological results of laparoscopic radical cystectomy with orthotopic ileal neobladder

目的:回顾分析腹腔镜下全膀胱切除+回肠原位新膀胱术的临床疗效与经验。方法:随访了2006年1月-2012年2月采用腹腔镜下根治性膀胱切除术+回肠原位新膀胱术治疗的87例患者,手术方法为腹腔镜下膀胱全切术+开放新膀胱构建及吻合,并对随访3年的临床数据进行总结分析。结果:大多数患者恢复良好,所有的新膀胱漏尿并发症均被有效处理;仅有1例患者因肠瘘行肠造口,3个月后行肠回纳;术后3年整体生存率为88.5%(77/87),无瘤生存率为92.2%(71/77);整体控尿功能及肾功能保护方面取得良好效果。结论:腹腔镜下根治性膀胱全切+回肠原位新膀胱术,具有良好的控尿功能和较好的保肾功能,可以明显提高患者生活质量。

Objective： To summarize the clinical curative effect and experience of orthotopic ileum bladder following radical cystectomy in the bladder cancer patients. Methods： January 2006 to February 2012,87 patients underwent radical cystectomy and orthotopic ileum bladder reconstruction,and summarize the 3 years clinical data of follow-up.Results： Most of the patients recovered well,all of the new bladder leakage complications were effective treated. Only one patient with major urinary leak required re-exploration with successful revision anastomosis. The 3-year survival rate after surgery was 88. 5%（ 77 /87）. The disease free survival proportion was 92. 2%（ 71 /77）. Effective daytime and nighttime urinary continence as well as renal function deterioration were great. Conclusion： Laparoscopic radical resection of bladder in situ ileum new bladder surgery has the good function of urinary continence and better protect renal function,significantly improving the patients quality of life.