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目的探讨腹腔镜根治性膀胱癌切除手术中膀胱侧韧带、后韧带及前列腺侧血管蒂的处理方法。方法根治术前先结扎髂内动脉分支以减少膀胱及前列腺动脉血供及静脉回流,对膀胱侧、后韧带及前列腺侧血管蒂的内、外侧缘充分游离后再进行切断处理。结果按设计的方法在56例手术中完成了对膀胱侧、后韧带及前列腺侧血管蒂的处理,根治手术时间平均170min,出血量平均160ml。其中每侧手术时间平均为4min,出血量10~20ml,无直肠损伤发生。结论采用本手术改进方法处理膀胱侧、后韧带及前列腺侧血管蒂,能有效缩短手术时间、减少出血及避免直肠损伤。
Objective To investigate the treatment of bladder ligaments, posterior ligaments and prostatic vessels in laparoscopic radical resection of bladder cancer. [Methods] The ligation of internal iliac artery branches was performed before radical surgery to reduce the blood supply and venous return of the bladder and prostatic artery. The lateral and posterior ligaments of the bladder, the posterior ligament and the prostatic vessels were completely dissociated and then cut off. Results According to the designed method, the treatment of bladder side, posterior ligament and prostatic side vascular pedicle was completed in 56 cases. The average operation time was 170 minutes and the average amount of bleeding was 160ml. The average operation time of each side was 4min, the amount of bleeding was 10 ~ 20ml, without rectal injury. Conclusion The method of this operation to improve the bladder side, posterior ligament and prostate pedicle, can effectively shorten the operation time, reduce bleeding and avoid rectal injury.