腹腔镜膀胱全切术治疗极高龄肌层浸润性膀胱癌临床效果观察

Laparoscopic total cystectomy for the treatment of advanced age with muscle invasive bladder cancer

目的探讨腹腔镜膀胱全切术治疗80岁以上极高龄肌层浸润性膀胱癌患者的临床疗效与安全性。方法选取2014年7月至2016年7月收治的80岁以上浸润性膀胱癌患者32例,所有患者均行腹腔镜膀胱全切术。观察并记录手术时间、术中失血量、术后住院时间及并发症发生情况等。结果 32例患者手术均获成功,无死亡,其中,4例中转开腹;平均手术时间为(181.0±40.3)min;平均术中出血量为(325.0±88.9)ml;平均术后住院时间为(10.0±2.8)d;术后发生肺部感染2例、下肢静脉血栓2例、应激性溃疡1例、切口感染1例。结论腹腔镜膀胱全切术治疗80岁以上极高龄肌层浸润性膀胱癌患者安全有效,可在临床推广应用。

Objective To investigate the clinical value of laparoscopic cystectomy in the treatment of bladder cancer patients over 80 years old. Methods A retrospective study was performed on 32 patients who were over 80 years old with muscle invasive bladder cancer underwent laparoscopic total cystectomy from July 2014 to July 2016. The operation time,intraoperative bleeding volume,postoperative hospital stay and complications were analyzed. Results All 32 cases of surgeries were successful,with no death. Among the patients,4 cases were converted to open surgery; the mean operation time was（ 181. 0 ± 40. 3） minutes,the mean bleeding volume was（ 325. 0 ± 88. 9） ml; the mean hospitalization time after operation was（ 10. 0 ± 2. 8） days; postoperative pulmonary infection in 2 cases,lower extremity venous thrombosis in 2 cases,stress ulcer in 1 case and incision infection in 1 case. Conclusion It is safe and effective to treat bladder cancer in advanced age over 80 years old with bladder cancer by laparoscopic cystectomy,which is worth of clinical promotion.