昆明医科大学学报2025，Vol.46Issue(6)：71-78,8.DOI:10.12259/j.issn.2095-610X.S20250609
完全性盆底腹膜重建技术在膀胱全切原位新膀胱术中的疗效分析
Efficacy Analysis of Complete Pelvic Floor Peritoneal Reconstruction Technique in Orthotopic Neobladder Surgery after Total Cystectomy
摘要
Abstract
Objective To evaluate the efficacy of complete pelvic floor peritoneal reconstruction in reducing postoperative ileus incidence and accelerating recovery following laparoscopic radical cystectomy with orthotopic neobladder construction.Methods A retrospective study was conducted to select 62 patients who underwent the operation in Qujing Hospital Affiliated to Kunming Medical University from January 2017 to September 2024.According to whether complete pelvic floor peritoneal reconstruction was performed during the operation,they were divided into the conventional group(n=25)and the reconstruction group(n=37).Postoperative ileus rates and recovery parameters were compared to assess the clinical value of complete pelvic floor peritoneal reconstruction.Results The reconstruction group showed better postoperative recovery compared to the routine group:gastrointestinal function recovery time[3(2,4)d vs 4(3,5)d,P=0.032],abdominal drainage time[12(10,13.5)d vs 14(12,15)d,P=0.006],pelvic drainage time[12(9,13.5)d vs 14(11,16)d,P=0.015],postoperative hospital stay[18(15.5,26)d vs 25(17,30.5)d,P=0.016],and hospital expenses[(53,695.67±10,182.43)yuan vs(60,803.73±14,449.24)yuan,P=0.027].Postoperative nutritional markers,including total protein[(64.49±6.82)g/L vs.(61.56±4.03)g/L,P=0.038]and albumin[(36.08±5.29)g/L vs.(33.40±3.57)g/L,P=0.020],were higher in the reconstruction group.No significant difference was found in ileus incidence(44.00%vs.32.43%,P=0.355).Other parameters—baseline characteristics,postoperative globulin and prealbumin levels,gastric tube retention,stent/catheter removal time,and complications(anastomotic leakage,urinary fistula,wound infection)—showed no intergroup differences(P>0.05).Conclusion The application of complete pelvic floor peritoneal reconstruction technique in laparoscopic radical cystectomy with orthotonic neobladder provides better protection for the intestine,reduces surgical area adhesions,promotes gastrointestinal function recovery,shortens abdominal and pelvic drainage times,accelerates patient rehabilitation,reduces hospital stay and expenses.However,whether it can effectively reduce postoperative intestinal obstruction rates still requires more data and experimental verification.关键词
膀胱癌/膀胱全切原位新膀胱术/完全性盆底腹膜重建技术/术后肠梗阻Key words
Bladder cancer/Radical cystectomy with orthotopic neobladder/Complete pelvic floor peritoneal reconstruction/Postoperative ileus分类
医药卫生引用本文复制引用
刘胜,袁飞,周红庆,刘明生,邹东桓,李钰,陈冠宇,郭峰..完全性盆底腹膜重建技术在膀胱全切原位新膀胱术中的疗效分析[J].昆明医科大学学报,2025,46(6):71-78,8.基金项目
国家自然科学基金(82160584) （82160584）
云南省中青年学术技术带头人后备人才(202105AC160013) （202105AC160013）
云南省科技厅-昆明医科大学应用基础研究联合专项基金(202301AY070001-060 （）
202401AY070001-139) （）
云南省教育厅科学研究基金(2023J0316 （）
2024J0391 （）
2024J0319) （）
昆明医科大学前列腺癌先进诊疗技术创新团队(CXTD202216) （CXTD202216）
昆明医科大学研究生教育创新基金(2024S392) （2024S392）
