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学科主题: 泌尿外科学
题名:
腹腔镜与开放根治性膀胱全切-回肠原位新膀胱术的疗效对比
其他题名: Comparison of laparoscopic and open surgery for radical cystectomy with orthotopic ileal neobladder
作者: 吴鑫; 刘沛; 朱雨泽; 郑卫; 唐琦; 姚林; 张崔建; 郝瀚; 李学松; 周利群
关键词: 膀胱肿瘤 ; 腹腔镜 ; 回肠新膀胱 ; 根治性膀胱切除 ; bladder cancer ; laparoscopy ; ileal neobladder ; radical cystectomy
刊名: 现代泌尿外科杂志
发表日期: 2015
DOI: 10.3969/j.issn.1009-8291.2015-04-006
期: 4, 页:229-233
收录类别: 中国科技核心期刊
文章类型: Journal Article
摘要: 目的:比较开放及腹腔镜根治性膀胱全切-回肠原位新膀胱术的临床疗效。方法回顾性分析我院自2010年9月至2014年3月行开放(ORC)及腹腔镜(LRC)根治性膀胱全切-回肠原位新膀胱术患者的资料,其中ORC组13例,LRC组21例。对两组患者的术前基本资料、围术期数据、术后并发症情况、术后控尿情况及肿瘤学随访数据进行对比分析。结果LRC组较ORC组具有术中出血量少(P=0.013)、术后恢复进食时间短(P=0.001)、住院时间短(P=0.005)的特点。两组在术后并发症发生率方面无明显差异(P=0.725)。所有患者术后切缘均为阴性,两组患者在淋巴结清扫个数(P=0.393)以及淋巴结阳性率(P=0.562)方面无统计学差。中位随访时间28.5个月(8~47个月)。在术后1年内,LRC组与ORC组在日间控尿率(88.2%vs.84.6%,P=0.773)及夜间控尿率(70.6%vs.76.9%,P=0.697)无明显差异。在随访过程中,4例患者发生肿瘤复发或转移,其中盆腔复发2例,脑转移1例,肺转移1例。3例患者死亡。LRC组与ORC组在肿瘤特异性生存率及无复发生存率上无统计学差异(P均>0.05)。结论与开放手术相比,腹腔镜根治性膀胱全切-回肠原位新膀胱术具有术中出血少、术后恢复快的特点,其术后控尿功能及肿瘤学结果与开放手术疗效相当,因此应作为首选手术方案。 Objective To compare the clinical outcomes of laparoscopic cystectomy (LRC) and open radical cystectomy (ORC) in the treatment of orthotopic ileal neobladder .Methods The demographic parameters of patients ,perioperative da-ta ,postoperative complications ,new bladder function and oncology results were recorded and evaluated .Results The LRC group had less estimated blood loss (P=0 .013) ,shorter oral intake time (P=0 .001) and hospital stay (P=0 .005) compared with the ORC group . There was no difference in postoperative complications ( P= 0 .725 ) , the mean number of dissected lymph nodes (P=0 .393) ,and lymph node positive rate (P=0 .562) between the two groups .The median follow-up was 28 .5 months (8~47 months) .One year after operation ,the day-time and night-time continence rate were 88 .2% and 70.6% for the LRC group ,84 .6% and 76 .9% for the ORC group (P>0 .05) ,with no statistical significance .During the follow-up ,4 patients developed tumor recurrence and metastasis .There was no significant difference in cancer-specific survival rates and re-currence-free survival rates between the two groups (all P>0 .05 ) .Conclusions Compared with open radical cystectomy , laparoscopic cystectomy has advantages of less blood loss ,earlier oral intake and shorter hospital stay in the treatment of ortho-topic ileal neobladder .Additionally ,it produces comparable continence and tumor control as open radical cystectomy;there-fore ,laparoscopic cystectomy should be the optimal treatment modality .
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/45463
Appears in Collections:北京大学第一临床医学院_泌尿外科_期刊论文

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作者单位: 北京大学第一医院泌尿外科北京大学泌尿外科研究所,北京,100034

Recommended Citation:
吴鑫,刘沛,朱雨泽,等. 腹腔镜与开放根治性膀胱全切-回肠原位新膀胱术的疗效对比[J]. 现代泌尿外科杂志,2015(4):229-233.
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