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目的探讨腹腔镜根治性膀胱全切输尿管皮肤造口手术方法和临床效果。方法 5例膀胱移行细胞癌患者,男性3人,女性2人,年龄68-72岁,均为T3N0M0膀胱多发肿瘤,4例行双侧输尿管造口术,1例行单侧输尿管造口术。观察手术时间、术中出血量、术后肠道功能恢复、术后并发症及手术效果。结果手术时间2.5-3.5 h,术中失血400-600 mL,平均出血量420 mL,术后约60-72 h肠道功能恢复,手术均未输血,手术切口甲级愈合,未出现腹腔并发症。结论本组共5例行经腹腔镜根治性膀胱全切输尿管皮肤造口,均取得满意效果,无腹腔并发症。该术式具有微创,出血少,恢复快等特点,随着技术的进步,该术式将成为治疗浸润性膀胱癌的较好方法之一。
Objective To investigate the method and clinical effect of laparoscopic radical cystectomy of ureter skin. Methods Five patients with transitional cell carcinoma of the bladder, including 3 males and 2 females, aged from 68 to 72 years old, all had T3N0M0 bladder multiple neoplasms. Bilateral ureterostomy was performed in 4 cases and unilateral ureteral ostomy in 1 case. Observe the operation time, intraoperative blood loss, postoperative intestinal function recovery, postoperative complications and surgical results. Results The operation time was 2.5-3.5 h, the intraoperative blood loss was 400-600 mL, the average amount of bleeding was 420 mL. The intestinal function recovered after about 60-72 h after operation. No blood transfusion was performed in the operation. The surgical incision was grade A and there was no abdominal complication . Conclusions This group of 5 patients underwent laparoscopic radical cystectomy of ureteric skin stoma successfully achieved satisfactory results without abdominal complications. The procedure has the characteristics of minimally invasive, less bleeding, rapid recovery, with the progress of technology, the operation will become one of the better ways to treat invasive bladder cancer.