论文部分内容阅读
目的:探讨完全腹腔镜下根治性膀胱全切除加原位回肠新膀胱术的临床可行性,并总结手术技巧。方法:对3例膀胱癌患者行腹腔镜下根治性膀胱全切术加扩大淋巴结清扫,并在腹腔镜下制备Studer新膀胱术。结果:3例手术均获成功,手术时间分别为510、470和450min,出血量300、150和210ml,淋巴结清扫数目为23、20(阳性1枚)和25枚,手术切缘阴性。术后第2天下地活动,第3天肠功能恢复,术后1个月行膀胱造影确定没有吻合口漏后拔除尿管和双侧输尿管支架管,无输尿管返流,肠漏和尿漏等并发症发生。术后住院时间分别为17、13和16天,术后随访分别为4、3和3个月,肾功能均正常,无复发或转移。结论:根据初期的手术操作过程和随访结果,完全腹腔镜下根治性膀胱全切除加原位回肠新膀胱术在临床上是可行的。更多的操作经验,长期和随机的对照研究将有助于对这一技术的评估和推广。
Objective: To investigate the clinical feasibility of total laparoscopic radical cystectomy combined with ileal neo-bladder surgery and to summarize the surgical techniques. Methods: Three cases of bladder cancer underwent laparoscopic radical cystectomy plus lymph node dissection, and laparoscopic preparation of new Bladder surgery. Results: All the three surgeries were successful. The operative time was 510, 470 and 450 min respectively. The bleeding volume was 300, 150 and 210 ml. The number of lymph node dissection was 23 and 20 (positive one) and 25, respectively. The surgical margins were negative. On the second day after operation, intestinal function was restored on day 3, and one-month postoperative urography was performed to confirm that there was no anastomotic leakage after removal of the ureter and bilateral ureteral stent tubes without ureteral reflux, bowel leakage and urinary leakage Complications occur. The postoperative hospital stay was 17, 13 and 16 days respectively. The postoperative follow-up was 4, 3 and 3 months respectively. The renal function was normal and no recurrence or metastasis was found. Conclusions: According to the initial surgical procedures and follow-up results, complete laparoscopic radical cystectomy with ileal neo-bladder surgery is clinically feasible. More operational experience, long-term and randomized controlled studies will help to evaluate and promote this technology.