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目的探讨保留前列腺的腹腔镜膀胱全切、回肠膀胱术的临床应用价值。方法回顾性分析2012年1月至2015年6月因膀胱癌在我院行保留前列腺的腹腔镜膀胱全切、回肠膀胱术的男性患者的临床资料,共10例患者,年龄37~45岁,中位年龄41岁,术前临床分期,T2N0M0。结果本组10例患者完成手术,手术时间220~340 min,中位时间250 min。术中出血量350~800 ml,中位出血量480 ml。术后随访6~24个月,术后6个月9例能勃起并完成射精,出现远处转移1例,行全身化疗,至今存活。结论保留前列腺的腹腔镜膀胱全切、回肠膀胱术术前患者要严格的选择,早期随访疗效满意,保留患者性功能明显,提高了年轻患者的生活质量。
Objective To investigate the value of laparoscopic total bladder resection and ileal bladder surgery for preserving the prostate. Methods From January 2012 to June 2015, clinical data of male patients undergoing laparoscopic total ileostomy and ileal bladder surgery for bladder cancer in our hospital from January 2012 to June 2015 were retrospectively analyzed. A total of 10 patients aged 37-45 years, The median age was 41 years old, preoperative clinical stage, T2N0M0. Results The group of 10 patients completed the operation, the operation time was 220 ~ 340 min, the median time was 250 min. Intraoperative blood loss of 350 ~ 800 ml, the median amount of bleeding 480 ml. All the patients were followed up for 6-24 months. Nine cases were erected and completed ejaculation 6 months after operation. One patient had distant metastasis and had systemic chemotherapy and survived to this day. Conclusions The laparoscopic resection of the prostate with total resection of the bladder and stricture of the ileal bladder prior to surgery should be performed with satisfactory results in early follow-up. The patient’s sexual function should be preserved and the quality of life of young patients should be improved.