腹腔镜下保留前列腺的膀胱全切除术

Laparoscopic prostate-sparing cystectomy:report of 10 cases

目的探讨保留前列腺的腹腔镜膀胱全切、回肠膀胱术的临床应用价值。方法回顾性分析2012年1月至2015年6月因膀胱癌在我院行保留前列腺的腹腔镜膀胱全切、回肠膀胱术的男性患者的临床资料,共10例患者,年龄37~45岁,中位年龄41岁,术前临床分期,T2N0M0。结果本组10例患者完成手术,手术时间220~340 min,中位时间250 min。术中出血量350~800 ml,中位出血量480 ml。术后随访6~24个月,术后6个月9例能勃起并完成射精,出现远处转移1例,行全身化疗,至今存活。结论保留前列腺的腹腔镜膀胱全切、回肠膀胱术术前患者要严格的选择,早期随访疗效满意,保留患者性功能明显,提高了年轻患者的生活质量。

Obiective To evaluate the clinical effectiveness of prostate sparing in laparoscopic radical cystectomy with ileal conduit. Methods The clinical data of 10 male patients who underwent prostate sparing laparoscopic radical cystectomy with ileal conduit from January 2012 to June 2015 were retrospectively analyzed. The age of the patients ranged from 37 to 45 years, and the median age was 41 years old. The clinical stage were all T2N0M0. Results Ten patients were all operated successfully. The mean operative time was 250 minutes （range 220-340 rain）. The blood loss was ranged from 350 ml to 800 ml, the median blood loss was 480 ml. They were followed for 6 to 24 months, 9 patients can have erection and ejaculation after 6 months. One patient had distant metastasis and was given chemotherapy, and still alive now. Conclusion Based on our early follow-up, the procedure oflaparoscopic prostate sparing radical cystectomy with ileal conduit obtain good functional results, but the patients must be strictly screened, sparing the function of erection and ejaculatory can greatly improve the patient＇s quality of life.