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目的探讨腹腔镜下根治性膀胱切除回肠通道术的术式。方法浸润性膀胱癌患者8例,男性6例,女性2例,年龄59~75岁,平均年龄67岁。腹腔镜下根治性膀胱切除,下腹正中4~5 cm切口取出标本,行回肠通道术。结果手术时间5~7 h,平均5.5 h,其中腹腔镜下操作时间190~260 min,平均215 min。出血量200~400 ml,平均260 ml。均未出现围手术期并发症,术后随访1~16个月,1例患者术后1个月复查发现输尿管吻合口狭窄,其余患者肾功能均正常,IVU检查未发现输尿管回肠吻合口狭窄或输尿管返流。结论腹腔镜下膀胱根治性切除回肠通道术创伤小、手术时间短、恢复快,是膀胱全切除中的对于老年患者适合开展的术式。
Objective To investigate the operative method of laparoscopic radical cystectomy of ileum. Methods 8 cases of invasive bladder cancer patients, 6 males and 2 females, aged 59 to 75 years, mean age 67 years. Laparoscopic radical cystectomy, the middle of the lower abdomen 4 ~ 5 cm incision to remove the specimens, ileus surgery. Results The operation time was 5 to 7 hours, with an average of 5.5 hours. Among them, laparoscopic operation time was 190-260 minutes (average 215 minutes). Bleeding volume 200 ~ 400 ml, an average of 260 ml. No perioperative complications occurred. The patients were followed up for 1 to 16 months. One patient was found to have ureteral anastomotic stenosis one month after operation. All the other patients had normal renal function. Ureteral anastomotic stenosis was not found in IVU or Ureteral reflux. Conclusions Laparoscopic radical cystectomy of ileum with small trauma, short operative time and fast recovery is the appropriate surgical procedure for elderly patients undergoing total cystectomy.