腹腔镜下全膀胱切除术12例临床分析

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1、腹腔镜下全膀胱切除术12例临床分析【摘要】「I的：介绍腹腔镜下全膀胱切除术的初步体会。方法:2006年1月至2008年12月治疗浸润性膀胱癌12例，男10例，女2例，年龄48〜69岁，无远处转移。腹腔镜下行全膀胱切除、前列腺切除或子宫次全切。经腹率造口取出切除物，行乙状结肠去带原位新膀胱术。结果:12例手术成功，腹腔镜下手术时间120〜280min(平均180min);W放原位新膀胱术190〜300min(平均240min)o腹腔镜下操作出血量400〜1000ml(平均600ml);术中、术肩输浓缩红细胞400〜600ml(平均500ml)o12例随访6〜36个月，平均15

2、个月。口天可控排尿10例(83.3%)轻度尿失禁2例(16.7%)°新膀胱容量180〜320ml(平均270ml),尿I'可隔吋间45〜120min(平均80min)o1例勃起功能障碍(术前4例有勃起功能)。患者血Cr和Bun正常,未出现酸中毒。结论:腹腔镜下全膀胱切除术是对行和值得临床推广应用。【关键词】腹腔镜；膀胱癌；全膀胱切除；尿流改道LaparoscopicRadicalCystectomyof12CasesCarcinomaofBladderWUGuo-ding,OUXiang-xin,LIQing-wen,etal(XinhuiHospitalAffiliate

3、dtoSouthMedicalUniversity,GuangdongJiangmen529100,China)Abstract:Objective:Tointroducethepreliminaryexperienceinlaparoscopictotalcystectomy.Method：FromJanuary2006toDecember2008,Wetreatedatotalof12casesofdistantmetastasis-freeinvasivebladdercancer.Therewere10maleand2female,48〜69yearsold.The

4、sepatientswereperformedprostatectomyorhysterectomydependingonthecircumstances.Patientswereperformedlaparoscopicradicalcystectomywithreconstructionofbladderwithsigmoid・Result：Alloperationsweresuccessfullycompletedwiththeoperationtimeof120〜280min(mean180min),withopenorthotopicneobladdertime1

5、90^300min(mean240min),thebloodloss400〜1000ml(mean600ml).Intraoperativeandpostoperative,transfusionofredbloodcellconcentrates400〜600ml(mean500ml).12caseswerefollowedupfor6〜36months(mean15).10casesvoidedsmoothlyduringtheday(83.3%),and2casesbecamemildincontinence(16.7%).Thenewbladdercapacityw

6、as180〜32()ml(mean270ml),thetimebetweenurinewas45~120min(mean80min).1casewaserectiledysfunctionaftersurgery(Erectilefunctionof4caseswerenormal).A11patients"CrandBunwasnormal.Acidosisdoesnotappear.Conclusion：LaparoscopicradicalcystectomyisfeasibleandworthyofclinicalapplicationKeywords:Laparo

7、scopy;Bladderneoplasms;Cystectomy;Urinarydiversion2006年1月至2(X)8年12月，我们对12例浸润性膀胱癌行腹腔镜下全膀胱切除术，效果满意。现报告如下。1资料与方法1.1一般资料:本组12例，男10例，女2例。年龄48〜69岁，平均62岁。其中2例伴糖尿病，3例伴慢性支气管炎，4例有阴茎勃起功能。术前均经膀胱镜检查活检，病理诊断均为膀胱移行上皮癌，无尿道转移。CT或MR检查，肿瘤直径1.8〜3.3cm,平均2.5cm,无膀胱外浸润及远处转移。所有患者心功能止常，