目的探讨腹膜外途径保留女性生殖器官的膀胱全切原位回肠膀胱术手术技术并评估其治疗效果和肿瘤学结果。方法收集2019年2月至2022年12月期间就诊于青岛大学附属医院泌尿外科12例患者的基本资料、手术时间、出血量、性生活质量、排尿控...目的探讨腹膜外途径保留女性生殖器官的膀胱全切原位回肠膀胱术手术技术并评估其治疗效果和肿瘤学结果。方法收集2019年2月至2022年12月期间就诊于青岛大学附属医院泌尿外科12例患者的基本资料、手术时间、出血量、性生活质量、排尿控制情况以及术后并发症的数据。定期随访患者的肿瘤和功能结局,术后使用女性性功能指数(Female Sexual Function Index,FSFI)评估性功能状况。结果回顾性分析12例平均年龄为51岁的接受保留生殖器官膀胱全切原位尿流改道术的女性患者。12例手术均顺利完成。平均手术时间(223.58±28.45)min,平均术中出血量(165.00±80.51)ml,术后病理切缘均显示阴性,无淋巴结转移。日间排尿可控制12例(100%),夜间排尿可控制10例(83.3%),患者术后平均FSFI评分为(21.9±1.2)分。结论对于经过筛选的女性膀胱癌患者,生殖器官保留技术是一种安全可行的手术策略。保存生殖器和血管神经束在肿瘤学上可能是安全的,临床疗效满意。展开更多
Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postopera...Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).展开更多
文摘目的探讨腹膜外途径保留女性生殖器官的膀胱全切原位回肠膀胱术手术技术并评估其治疗效果和肿瘤学结果。方法收集2019年2月至2022年12月期间就诊于青岛大学附属医院泌尿外科12例患者的基本资料、手术时间、出血量、性生活质量、排尿控制情况以及术后并发症的数据。定期随访患者的肿瘤和功能结局,术后使用女性性功能指数(Female Sexual Function Index,FSFI)评估性功能状况。结果回顾性分析12例平均年龄为51岁的接受保留生殖器官膀胱全切原位尿流改道术的女性患者。12例手术均顺利完成。平均手术时间(223.58±28.45)min,平均术中出血量(165.00±80.51)ml,术后病理切缘均显示阴性,无淋巴结转移。日间排尿可控制12例(100%),夜间排尿可控制10例(83.3%),患者术后平均FSFI评分为(21.9±1.2)分。结论对于经过筛选的女性膀胱癌患者,生殖器官保留技术是一种安全可行的手术策略。保存生殖器和血管神经束在肿瘤学上可能是安全的,临床疗效满意。
基金Earlier version of this article was presented as a poster in the bladder section:invasive(MP 13-12)AUA-2021.
文摘Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).