根治性全膀胱切除术联合回肠新膀胱术治疗膀胱癌的疗效观察

Observation Efficacy of Radical Total Cystectomy Combined with Ileal Neo-bladder Operation in Treatment of Patients with Bladder Cancer

目的观察根治性全膀胱切除术联合回肠新膀胱术常规尿流改道治疗膀胱癌的临床价值。方法选取我院2017年5月-2018年4月收治的膀胱癌患者160例,按手术方式不同分为对照组和观察组,每组80例。观察组给予完全腹腔镜下根治性全膀胱切除术联合原位U形回肠新膀胱术,对照组给予完全腹腔镜下根治性全膀胱切除术联合常规尿流改道术。比较2组手术情况(手术时间、术中出血、术后住院时间)、术后尿动力学(残余尿量、最大尿流率、膀胱内压、膀胱容量)改变、术后并发症发生率及随访1年生活质量的变化。结果 2组手术情况、术后并发症发生率比较差异无统计学意义(P>0.05);观察组残余尿量低于对照组,最大尿流率、膀胱内压、膀胱容量及随访不同时间生活质量评分均高于对照组(P<0.05)。结论回肠新膀胱术治疗膀胱癌安全可行,可促进患者排尿功能恢复。

Objective To observe the clinical value of radical total cystectomy combined with ileal neo-bladder operation in treatment of patients with bladder cancer. Methods From May 2017 to April 2018, 160 patients with bladder cancer were selected and divided into the control group(n=80) and the observation group(n=80) according to the operation mode. The observation group was treated with pure laparoscopic radical cystectomy + in situ U-shaped ileal neo-bladder operation, while the control group was treated with pure laparoscopic radical cystectomy + conventional urinary diversion. The operative conditions(duration of operation, intraoperative bleeding, postoperative hospital stay), postoperative urodynamics(residual urine volume, maximum urine flow rate, intravesical pressure, bladder volume), postoperative complications and quality of life were compared between the two groups. Results There was no significant difference between the two groups in terms of operative conditions and postoperative complications(P>0.05), The residual urine volume of the observation group was lower than that of the control group, and the maximum urine flow rate, intravesical pressure, bladder volume and the quality of life scores at different time of follow-up were higher than those of the control group(P<0.05). Conclusion Ileal neo-bladder operation is safe and feasible in the treatment of bladder cancer, which can promote the recovery of urinary function.