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目的:探讨腹腔镜全膀胱根治术的手术方法及其临床效果。方法:均采用气管插管麻醉。腹腔镜下切除膀胱和前列腺。结果:手术时间为256～476分钟,平均为368分钟;术中出血量为100～400ml,平均为248ml。肠道恢复时间为术后1～3天,平均为1.5天。术后2～4天开始进食。手术后8～13天痊愈出院。手术后病理报告:4例均为膀胱移行细胞癌Ⅱ～Ⅲ级,其中3例浸润浅肌层。手术中和手术后均未发生并发症。手术后随访6～9个月,一般状况良好,无肿瘤复发及转移。结论:腹腔镜全膀胱根治术具有创伤小、解剖清晰、术中出血少和术后恢复快等优点,是一种安全、有效的治疗方法。
Objective: To investigate the surgical method and its clinical effect of laparoscopic total cystectomy. Methods: Tracheal intubation anesthesia were used. Laparoscopic removal of the bladder and prostate. Results: The operation time ranged from 256 to 476 minutes with an average of 368 minutes. The intraoperative blood loss was 100 to 400 ml with an average of 248 ml. Intestinal recovery time after 1 to 3 days, an average of 1.5 days. After 2 to 4 days to start eating. 8 to 13 days after surgery cured. Postoperative pathology report: 4 cases were transitional cell carcinoma of the bladder Ⅱ ~ Ⅲ grade, of which 3 cases of superficial myometrial invasion. No complications occurred during or after surgery. Follow-up 6 to 9 months after surgery, the general condition is good, no tumor recurrence and metastasis. Conclusions: Laparoscopic radical cystectomy has the advantages of less trauma, clear anatomy, less intraoperative bleeding and faster postoperative recovery. It is a safe and effective treatment.