中国内镜杂志2017，Vol.23Issue(1)：74-79,6.DOI:10.3969/j.issn.1007-1989.2017.01.015
腹腔镜根治性膀胱全切+原位回肠新膀胱术治疗浸润性膀胱癌
Laparoscopic radical cystectomy and orthotopic ileal neobladder used for treatment of invasive bladder cancer
梁天才 1杜江 1李浩 1余浪 1王敏 1梁国标 1杜洋 1王欣 1王远亮 1陈安健 1陈宗平 1郭亚南1
作者信息
- 1. 遵义医学院附属医院 泌尿外科，贵州 遵义 563000
- 折叠
摘要
Abstract
Objective To investigate the surgical methods and experience of laparoscopic radical cystectomy and orthotopic ileal neobladder for invasive bladder cancer. Methods The clinical data of 14 patients with invasive bladder cancer underwent laparoscopic radical cystectomy and orthotopic ileal neobladder were collected retrospectively during March 2011 and October 2014. Results The 13 patients with invasive bladder cancer were successfully completed laparoscopic radical cystectomy and orthotopic ileal neobladder. 1 case was treated with laparotomy because of unsatisfactory surgery ifeld caused by excessive tumor bleeding. Twelve cases of the urethra-neobaldder anastomosis were completed through the abdominal incision, while for the other 2 cases, the anastomosis was done under the laparoscope, 2 cases were performed neovesicourethral anastomosis using single-needle running sutures through laparoscopy. The median operative time was 444 minutes, the mean intraoperative blood loss was 490 ml. Postoperative pathologic results conifrmed that 12 cases were bladder transitional cell carcinoma (1 case with partial squamous cell carcinoma) and 2 cases with bladder adenocarcinoma. No severe complication occurred except for 2 cases of urinary leakage and 1 case of urinary incontinence. Patients were followed up for 6-56 months,within which 3 patients were died of distant metastasis, 1 case was detected with intracranial metastasis, 1 case was found with urethra-vesical anastomotic stenosis while cured after urethrotomy. Ten cases were well recovered and the mean volume of the neobladder was 300 ml. Conclusions Laparoscopic radical cystectomy and orthotopic ileal neobladder have the advantage of better therapeutic effects, safety, minimal invasion and rapid recovery, which are the preferred therapeutic methods for invasive bladder cancer.关键词
腹腔镜/膀胱癌/根治性膀胱切除术/原位回肠新膀胱术Key words
laparoscopy/bladder carcinoma/radical cystectomy/orthotopic ileal neobladder分类
医药卫生引用本文复制引用
梁天才,杜江,李浩,余浪,王敏,梁国标,杜洋,王欣,王远亮,陈安健,陈宗平,郭亚南..腹腔镜根治性膀胱全切+原位回肠新膀胱术治疗浸润性膀胱癌[J].中国内镜杂志,2017,23(1):74-79,6.
