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[目的]探讨高龄膀胱癌患者接受全膀胱切除术的临床病理特点,围手术期并发症和疗效。[方法]回顾性分析2012年1月至2016年12月间年龄≥75岁,接受全膀胱切除术的高龄患者,收集患者的临床病理信息,统计学分析患者围手术期并发症及生存情况。[结果]57例年龄≥75岁,在我院接受全膀胱切除术的高龄患者,尿流改道方式分别为回肠膀胱术13例和输尿管皮肤造口术44例,无一例患者在围手术期间死亡。22例(38.6%)患者出现围手术期并发症。常见的并发症包括感染、肠梗阻、肾盂输尿管积水等。无复发生存时间(RFS)为11.4个月,中位总生存时间为15.8个月。回肠膀胱术和输尿管皮肤造口术两种尿流改道术式的RFS无统计学差异。[结论]肌层浸润或高危复发的高龄膀胱癌患者,全膀胱切除术并发症发生率可以接受。在合适的患者身上,尿流改道应尽可能选用回肠膀胱术。
[Objective] To investigate the clinical and pathological features, perioperative complications and curative effects of patients with advanced bladder cancer undergoing total cystectomy. [Methods] A retrospective analysis of elderly patients aged> 75 years and undergoing total cystectomy between January 2012 and December 2016 was performed. The clinical and pathological information was collected and the perioperative complications and survival were statistically analyzed. [Results] Among the 57 elderly patients aged 75 years and undergoing total cystectomy in our hospital, there were 13 cases of urinary diversion and 44 cases of ureteric skin ostomy, respectively. No patient died during perioperative period . Perioperative complications occurred in 22 patients (38.6%). Common complications include infection, intestinal obstruction, ureter hydronephrosis and so on. The recurrence-free survival (RFS) was 11.4 months and the median overall survival was 15.8 months. Ileal and bladder urethroplasty ostomy two urinary diversion RFS no statistically significant difference. [Conclusion] The incidence of total cystectomy complications in elderly bladder cancer patients with myometrial invasion or high-risk relapse is acceptable. In the right patient, urinary diversion should be used as possible ileal bladder surgery.