腹腔镜下根治性膀胱切除和回肠通道术治疗肌层浸润型膀胱癌的临床研究

Clinical study on laparoscopic radical bladder dissection and ileal conduit in treatment of myometrial invasive bladder cancer

目的探析腹腔镜下根治性膀胱切除和回肠通道术治疗肌层浸润型膀胱癌的临床效果。方法选取2015年6月~2018年6月在我院接受治疗的31例肌层浸润型膀胱癌患者作为主要研究对象,根据入院时间先后将其分为两组,对照组(n=15)采用开放根治术治疗,观察组(n=16)则采用腹腔镜下根治性膀胱切除+回肠通道术治疗,比较两组的治疗效果。结果通过比较两组患者的手术指标,发现两组的手术时间比较差异无统计学意义(P>0.05),而观察组患者的术中出血量明显少于对照组,差异有统计学意义(P<0.05)。通过比较两组患者的术后指标,发现观察组患者的术后肛门排气时间、饮食恢复时间、住院时间均明显短于对照组,组间比较差异有统计学意义(P<0.05);通过比较两组患者的术后并发症发生率,发现观察组的并发症发生率明显低于对照组,两组相比差异有统计学意义(P<0.05)。从两组的术后复发情况上来看,观察组的术后复发率显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论对肌层浸润型膀胱癌患者采用腹腔镜下根治性膀胱切除+回肠通道术治疗可获得理想效果,能够减少患者的出血量,优化术后指标,且患者的并发症发生率和复发率低,能够提升患者的生存质量,值得进一步推广和应用。

Objective To explore the clinical effect of laparoscopic radical bladder dissection and ileal conduit in treatment of myometrialinvasive bladder cancer. Methods Thirty-one patients with myometrial invasive bladder cancer who were treated in our hospital from June 2015 to June 2018 were selected as the main research objects. They were divided into two groups according to admission time. The control group (n=15) was treated with open radical surgery while the observation group (n=16) was treated with laparoscopic radical bladder dissection combined with ileal conduit. Curative effects of the two groups were compared. Results There was no significant difference in operation time between the two groups(P > 0.05), but the intraoperative blood loss in the observation group was significantly less than that in the control group. The difference between the two groups was statistically significant(P< 0.05). The time of anal exhaust after operation, dietary recovery time and hospital stay in the observation group were significantly shorter than those in the control group, and the difference between the two groups was statistically significant (P < 0.05). The incidence of postoperative complications in the observation group was significantly higher than that in the control group and the difference between the two groups was statistically significant (P < 0.05). The recurrence rate in the observation group was significantly lower than that in the control group, and there werestatistically significant differences between the two groups (P < 0.05). Conclusion Laparoscopic radical bladder dissection and ileal conduit in treatment of patients with myometrialinvasive bladder cancer has an ideal effect. It can reduce the blood loss of patients and optimize the postoperative indicators. The incidence of complications and recurrence rate of patients are low. It can improve the quality of life of patients, which is worth further promotion and application.