目的:探讨机器人腹腔镜根治性膀胱切除术治疗肌层浸润性膀胱癌的安全性和可行性。方法:2014年10月至2015年11月,我院开展机器人辅助腹腔镜根治性膀胱切除术73例,其中男66例、女7例,平均年龄64.2(36~87)岁,现分析总结73例的临床疗效。结果:73例手术均获成功,无中转开放手术。手术时间167~384min,平均(275.7±59.8)min;膀胱切除时间43~120min,平均(73.4±18.9)min;术中出血量50~700ml,平均(289±161)ml。12例(16.4%)术中输血。术后肠道功能恢复时间3.4(2~5)d,术后平均住院时间11(6~26)d。术后发生并发症11例(13.70%),其中不全肠梗阻7例、切口感染3例、切口裂开1例,均经保守治疗痊愈。术后随访6(1~14)个月,6例死亡(8.22%),4例复发(5.48%)。结论:应用改良整体法行机器人辅助腹腔镜根治性膀胱切除术,使复杂的手术趋于简单化和程序化,能明显缩短手术时间、减少出血量、降低并发症发生率,近期疗效满意,值得进一步推广应用。 Objective: To investigate the safety and feasibility of robotic laparoscopic radical cystectomy for myometrial invasive bladder cancer. Methods: From October 2014 to November 2015, 73 cases of robotic assisted laparoscopic radical cystectomy were performed in our hospital, including 66 males and 7 females, with an average age of 64.2 (36-87 years). Analysis of 73 Cases of clinical efficacy. Results: All the 73 surgeries were successful and there was no transfer to open surgery. The operative time was 167-384 minutes with an average of (275.7 ± 59.8) min. The time of bladder resection was 43-120 minutes (mean, 73.4 ± 18.9) min. The mean intraoperative blood loss was 50-700 ml (mean, 289 ± 161) ml. Twelve patients (16.4%) had intraoperative blood transfusions. Postoperative intestinal function recovery time 3.4 (2 ~ 5) d, postoperative average length of stay 11 (6 ~ 26) d. Postoperative complications occurred in 11 cases (13.70%), including intestinal obstruction in 7 cases, incision infection in 3 cases, incision rupture in 1 case, were cured by conservative treatment. Six patients were followed up for 6 (1 ~ 14) months. Six patients died (8.22%) and four patients relapsed (5.48%). Conclusions: The modified whole-body robotic assisted laparoscopic radical cystectomy can simplify and program complex surgery, shorten the operation time, reduce the amount of bleeding and reduce the incidence of complications. The short-term curative effect is satisfactory Further promote the application.