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目的:比较膀胱肿瘤患者膀胱全切术后行原位新膀胱术与回肠膀胱术的临床治疗效果及术后早期并发症。方法:选择我院2000～2009年行根治性膀胱切除术治疗膀胱尿路上皮细胞癌65例患者的临床资料,其中行原位新膀胱术31例,回肠膀胱术34例。比较两组一般情况、围手术期情况(术中失血量、手术时间、肠功能恢复时间、住院天数)以及术后早期并发症等指标。结果:两种术式在术中失血量(1140.32±492.82 ml vs 920.91±410.48 ml)、手术时间(464.81±79.37 min vs 413.32±99.54 min)、住院天数(47.68±7.53天vs 41.09±8.12天)等方面差异有统计学意义(P<0.05)。结论:原位新膀胱术较回肠膀胱术虽手术步骤复杂,术中出血较多,但因手术安全,可自主性控制排尿,明显提高患者的生活质量而易于接受,是值得推荐的膀胱替代手术方式,在根治性膀胱切除术中值得优先采用。
OBJECTIVE: To compare the clinical effects of neobladder versus ileal bladder surgery after bladder resection in patients with bladder cancer and early postoperative complications. Methods: The clinical data of 65 cases of bladder urothelial carcinoma treated by radical cystectomy from 2000 to 2009 in our hospital were selected. Among them, 31 cases were treated with neobladder in situ and 34 cases with ileal bladder surgery. The general conditions, perioperative conditions (blood loss during operation, operation time, recovery time of intestinal function, days of hospitalization) and early postoperative complications were compared between the two groups. Results: The blood loss (1140.32 ± 492.82 ml vs 920.91 ± 410.48 ml), operative time (464.81 ± 79.37 min vs 413.32 ± 99.54 min), length of hospital stay (47.68 ± 7.53 days vs 41.09 ± 8.12 days) There were significant differences (P <0.05). CONCLUSIONS: In situ neobladder versus ileal Bladder Surgery is a more recommendable alternative to Bladder Surgery because of the complicated surgical procedures and more intraoperative bleeding. However, due to the safety of operation and autonomy in controlling urination, the quality of life of patients is significantly improved and easily accepted Way, worthy of priority in radical cystectomy.