腹腔镜根治性膀胱切除与开放手术的近期疗效比较

Comparison of short-term curative effect between laparoscopic radical cystectomy and open surgery

目的:比较腹腔镜与开放根治性膀胱切除术的近期疗效。方法:回顾性分析我院2013年10月~2015年11月施行的87例根治性膀胱切除术的患者临床资料,其中腹腔镜根治性膀胱切除术组(LRC组)48例,开放根治性膀胱切除术组(ORC组)39例,对比分析两组的围手术期及预后情况。结果:LRC组术中出血量、术后排气时间、拔除引流管时间、术后疼痛评分、术后住院时间均低于ORC组,差异均有统计学意义(P<0.05),但手术时间两组差异无统计学意义(P>0.05)。两组术后感染、出血、输尿管狭窄、淋巴漏、尿瘘及复发发生率的差异也无统计学意义(P>0.05),但LRC组术后肠梗阻发生率低于ORC组,差异有统计学意义(P<0.05)。结论:腹腔镜根治性膀胱切除治疗浸润性膀胱癌是安全可行的,且较开腹手术具有一定优势,近期疗效肯定。

Objective：To analyze the short-term curative effect of laparoscopic and open radical cystectomy.Method：A retrospective analysis was made on clinical data of 87 cases of radical cystectomy in our department from October 2013 to November 2015,among which,there were 48 cases undergoing the laparoscopic radical cystectomy and 39 cases undergoing the open radical cystectomy.The perioperative period and prognosis condition of two groups were compared and studied.Result：The intraoperative blood loss,postoperative exhaust time,remove time of drainage tube,postoperative pain score and length of postoperative hospital stay of the laparoscopic group were all less than those of the open surgery group,and the difference had statistical significance（P〈0.05）.The difference between two groups in postoperative infection,hemorrhage,ureteral stricture,lymphatic leakage,urinary fistula and recurrence rate had no statistical significance（P〉0.05）.The occurrence rate of postoperative ileus in the laparoscopic group was lower than that of the open surgery group,and the difference had statistical significance（P〈0.05）.Conclusion：Treating invasive bladder cancer with laparoscopic radical cystectomy is safe and feasible,and it shows certain advantages compared with open surgery with a definite short-term curative effect.