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目的:探讨肌层浸润性膀胱癌行根治性膀胱切除加回肠膀胱术保留腹膜完整性,对患者术后庝痛、胃肠功能恢复和肠梗阻等并发症的发生率的影响。方法:行根治性膀胱切除回肠膀胱术中,根据腹膜破损及修复情况设计为腹膜完整组和腹膜非完整组,其中腹膜完整组30例,腹膜非完整组37例;比较两组平均手术时间、出血量、术后庝痛时间、镇痛剂应用时间、保留胃管时间、排便时间、肠道功能恢复时间、住院时间及肠梗阻等并发症发生率等参数。结果:两组平均手术时间、出血量差异无统计学意义(P>0.05),术后庝痛时间、镇痛药物使用时间、保留胃管时间、排便时间、胃肠功能恢复、住院时间及肠梗阻(3.3%,22.0%)等并发症发生率差异有统计学意义(P<0.05)。结论:根治性膀胱切除回肠膀胱术保留腹膜完整性不影响手术时间和出血量,可以减轻术后庝痛、有利于术后肠道恢复及降低肠梗阻发生率,缩短住院时间。
Objective: To investigate the effect of radical cystectomy plus ileal bladder surgery on the peritoneal integrity of myometrial invasive bladder cancer and the incidence of postoperative pain, gastrointestinal function recovery and intestinal obstruction. Methods: In the radical cystectomy and ileal bladder surgery, according to peritoneal damage and repair, the intact peritoneum and peritoneal non-intact group were designed, including 30 peritoneal complete group and 37 nonperitoneal peritoneum group. The mean operation time, Bleeding time, postoperative pain time, analgesic application time, retention of gastric tube time, defecation time, intestinal function recovery time, hospitalization time and the incidence of complications such as intestinal obstruction and other parameters. Results: There was no significant difference between the two groups in average operation time and bleeding volume (P> 0.05), postoperative pain time, time of analgesic drug use, gastric tube reservation time, defecation time, gastrointestinal function recovery, hospital stay and intestine Obstruction (3.3%, 22.0%) and other complications were significantly different (P <0.05). Conclusions: Radical cystectomy ileostomy preserving peritoneal integrity does not affect the operation time and bleeding volume. It can reduce postoperative pain, is conducive to postoperative intestinal recovery and reduce the incidence of intestinal obstruction and shorten the hospital stay.