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[目的]探讨老年膀胱癌腹腔镜下膀胱全切除的手术方法和临床效果。[方法]老年膀胱癌患者12例,采用5个Trocar,腹腔镜下行膀胱根治性切除术,下腹正中做小切口,取出切除的膀胱、前列腺、子宫、附件。尿流改道方式回肠膀胱术患者9例,直肠膀胱术患者3例。[结果]手术时间4～7h,平均手术时间5.3h;术中失血400～650ml,平均约542 ml。术后禁食时间3~7d,平均3.7d。随访时间1~35个月,1例复发于术后5个月死亡,其余病例均生存。[结论]对老年肌层浸润性膀胱癌患者采取腹腔镜下根治性全膀胱切除术是临床上一种常用的有效的治疗方法。
[Objective] To investigate the surgical method and clinical effect of laparoscopic total cystectomy in elderly patients with bladder cancer. [Methods] Twelve elderly patients with bladder cancer were treated with five Trocar and laparoscopic radical cystectomy. Small incision was made in the middle of the lower abdomen, and the excised bladder, prostate, uterus and appendix were removed. Urinary diversion in patients with ileal bladder surgery in 9 cases, 3 cases of patients with rectal bladder surgery. [Results] The operation time was 4 to 7 hours, the average operation time was 5.3 hours. The intraoperative blood loss was 400 ~ 650ml, with an average of 542 ml. Postoperative fasting time 3 ~ 7d, an average of 3.7d. The follow-up time ranged from 1 to 35 months. One patient relapsed after 5 months of operation and the rest survived. [Conclusion] Laparoscopic radical cystectomy is a common and effective treatment for elderly patients with myometrial invasive bladder cancer.