[精品]腹腔镜与开放膀胱根治性切除―原位回肠新膀胱术的临床效果比较.doc

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1、腹腔镜与开放膀胱根治性切除一原位回肠新膀胱术的临床效果比较腹腔镜与开放膀胱根治性切除一原位回肠新膀胱术的临床效果比较［摘耍］目的比较腹腔镜与开放膀胱根治性切除-原位回肠新膀胱术治疗侵润性膀胱癌患者的临床效果。方法冋顾性分析该院自2009年1月一2012年6月收治的36例侵润性膀胱癌患者的临床资料,按照不同术式分为腹腔镜组(n=16)和开放手术组(n=20)o比较两组患者围手术期情况、术后并发症和术后1年的膀胱功能。结果观察组手术时间明显长于对照组［(366.8±42.5)minvs(308.4±38.2)min］,而术中出血量［

2、(482・3±23.5)mLvs(1078.3±344.6)mL］和术后住院时间［(22.8±3.7)dvs(28・6±4・9)d］均明显小于对照组，差异有统计学意义(P<0.05)o观察组术后并发症明显少于对照组，差异有统计学意义(P〈0・05)；而两组患者术后1年的膀胱容量、膀胱内压和残余尿差异无统计学意义(P〉0・05)。结论腹腔镜下膀胱根治性切除术-原位回肠新膀胱术对机体损伤小、术后恢复快和并发症较少的优点，且术后膀胱功能与开放手术相当，是一种值得推广应用的术式。［关键词］腹腔镜；开放手术；膀胱根治性切除；原位回肠新膀胱

3、术；效果［中图分类号］R737.14［文献标识码］A［文章编号］1674-0742(2014)05(a)-0034-02［Abstract］ObjectiveTocomparetheclinicaleffectof1aparoscopicandopenradicalresectionofbladderinsituileumnewbladdersurgeryforthetreatmentofpatientswithinvasivebladdercancer・MethodsTheclinicaldataof36patientswit

4、hinvasivebladdercanceradmittedinourhospitaifromJanuary,2009toJune,2012wereretrospectiveanalyzed・Andtheyweredividedinto1aparoscopicgroup(observationgroup,n=16)andopensurgicalgroup(controlgroup,n=20)accordingtothedifferentoperation.Theperioperativestatusandpostoperativ

5、ecomplicationsandbladderfunction1yearaftertheoperationwerecomparedbetweenthetwogroups・ResultsTheoperationtimeoftheobservationgroupwassignificantlylongerthanthatofthecontrolgroup[(366.8+42.5)minvs(308.4+38.2)min],whiletheintraoperatvebloodloss[(482.3±23.5)mlvs(1078.3+

6、344.6)ml]andlengthofstay[(22.8±3.7)dvs(28.6±4.9)d]weresmallerthanthoseofthecontrolgroup,thedifferenceswerestatisticallysignificant(allP〈0・05)・Thepostoperativecomplicationsoftheobservationgroupwasobviouslylessthanthoseofthecontrolgroup,thedifferencewasstatisticallysig

7、nificant(P<0.05)；andthedifferencesinbladdercapacity,intravesicalpressureandresidualurineinbladder1yearaftertheoperationbetweenthetwogroupswerenotstatisticallysignificant(allP〉0・05)・ConclusionLaparoscopicradicalresectionofbladderinsituileumnewbladdersurgeryhastheadvan

8、tagesofcausingminimaldamagetothebody,postoperativerecoverfaster,fewercomplications,andthepostoperativebladderfunctionisequivalentto