腹腔镜膀胱癌根治术治疗膀胱癌26例临床观察

Clinical observation on laparoscopic radical cystectomy in the treatment of 26 cases of bladder cancer

目的研究腹腔镜膀胱癌根治术治疗膀胱癌的手术效果。方法选取2016年1月~2017年1月我院应用腹腔镜膀胱癌根治术治疗的膀胱癌患者26例为腹腔镜组,另选择同期行开放性根治性膀胱切除术患者20例作为对照组。比较两组的手术时间、平均出血量、术后肠功能恢复时间、住院时间及并发症情况。并发症主要包括切口感染、术后出血、肠梗阻、尿失禁、切口脂肪液化。结果腹腔镜组患者的手术时间与对照组比较无显著性差异,而腹腔镜组患者的平均出血量明显少于对照组,术后肠功能恢复时间、住院时间短于对照组,差异具有显著性(P<0.05)。腹腔镜组术后无一例出现切口感染、尿失禁、切口脂肪液化,其并发症的发生率7.7%,显著低于对照组,差异具有显著性(P<0.05)。结论腹腔镜膀胱癌根治术治疗膀胱癌具有较好的临床手术效果及安全性,较传统开放性手术具有出血少、并发症少、术后恢复快等优势,值得广泛推广和应用。

Objective To study the surgical effect of laparoscopic radical cystectomy in the treatment of bladder cancer.Methods26patients with bladder cancer treated with laparoscopic radical cystectomy in our hospital from January2016to January2017were selected as laparoscopic group.Another20patients undergoing open radical cystectomy at the same period were selected as control group.The operation time,mean amount of bleeding,recovery time of intestinal function,hospitalization time and complications between the two groups were compared.Complications included incision infection,postoperative bleeding,intestinal obstruction,urinary incontinence,incision fat liquefaction.Results There was no significant difference in operative time between patients in laparoscopic group and control group.The mean bleeding volume of laparoscopic group was significantly less than that of control group.The recovery time of intestinal function and hospitalization time was shorter than that of control group,and the difference was significant between two groups(P<0.05).No incision infection,urinary incontinence and incision fat liquefaction occurred in the laparoscopic group.The incidence of complications was7.7%in the laparoscopic group,which was significantly lower than that of the control group(P<0.05).Conclusion Laparoscopic radical cystectomy has better clinical effect and safety in treating bladder cancer and has the advantages of less bleeding,less complications and quick recovery after operation compared with traditional open surgery,which is worth popularizing and applying widely.