根治性膀胱切除-回肠膀胱术的腹腔镜与开放手术疗效比较

Comparison of laparoscopic and open surgery for radical cystectomy with ileal conduit

目的比较根治性膀胱切除-回肠膀胱术的腹腔镜(LRC)与开放(ORC)手术疗效。方法回顾性分析76例行LRC或ORC-回肠膀胱术患者的临床资料,41例行LRC,35例行ORC,比较两组患者一般资料、围手术期资料、病理结果及术后并发症等。结果 76例手术均顺利完成。LRC组与ORC组的手术时间差异无统计学意义,LRC组的估计出血量、输血率、术中输血量、进食时间及术后下床活动时间均显著优于ORC组,LRC组Clavien-Ⅱ级以上的并发症显著低于ORC组。两组术后病理分期分级、淋巴结转移差异无统计学意义。结论与ORC相比,LRC可显著降低术中输血率和输血量,促进早期下床和经口进食,降低手术相关并发症。

Objective To compare operative efficacy between laparoscopic radical cystectomy(LRC) and open radical cystectomy(ORC) with ileal conduit.Methods A total of 76 patients who underwent radical cystectomy were evaluated retrospectively,including 41 cases with LRC and 35 cases with ORC.The general data,perioperative data,pathological results and postoperative complications of two groups were compared.Results All the operations were completed successfully.There is no significant difference in the operative time in LRC and ORC group. Estimated blood loss, transfusion rate, intraoperative blood transfusion volume, oral intake time after operation and postoperative ambulation time of LRC group were significantly better than ORC group. Rates of complications above Clavien-II in LRC was significantly lower than in ORC group. No significant difference was found in postoperative pathological staging, grading and lymph node metastasis.Conclusion Compared to ORC,LRC can lower transfusion rate and intraoperative blood transfusion volume,contribute to promote early ambulation and oral intake,and reduce procedure-related complications.