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目的探讨腹腔镜根治性膀胱切除+原位回肠膀胱术治疗老年膀胱癌患者的安全性及有效性。方法选择我院2015年1~12月共10例老年肌层浸润性膀胱癌患者,行腹腔镜根治性膀胱切除+原位回肠膀胱术,对患者的治疗效果及并发症进行回顾性分析。结果 10例患者的手术时间为4~7.5 h,平均(5.1±2.4)h。其中1例患者出血量为1100 mL,术中进行输血,其余9例患者的出血量为100~600 mL,平均出血量为(260±314)mL,均未输血。患者的术后胃肠功能恢复时间为1~8 d,平均(3.6±4.2)d。患者术后恢复良好,未出现尿瘘、肠瘘等并发症。术后1周内将回肠膀胱内留置的双腔尿管进行拔除,收集尿液。术后4周将单J管进行拔除,随访时间为3~6个月,患者肾功能均保持正常,经肾脏B超检查后未出现肾积水,胸部平扫CT及盆腔平扫CT检查后,肿瘤未出现复发及转移。结论腹腔镜膀胱根治性切除+原位回肠膀胱术治疗膀胱癌患者疗效良好,创伤小、出血少、术后恢复快,是一种安全有效的手术方法,值得进一步研究应用。
Objective To investigate the safety and efficacy of laparoscopic radical cystectomy + ileum bladder surgery in the treatment of elderly patients with bladder cancer. Methods A total of 10 elderly patients with myometrial invasive bladder cancer were selected from January 2015 to December 2015 in our hospital. The patients underwent laparoscopic radical cystectomy and ileal ileal bladder surgery. The therapeutic effects and complications were analyzed retrospectively. Results The operation time of 10 patients was 4 ~ 7.5 h, with an average of (5.1 ± 2.4) h. Among them, one patient had a blood loss of 1100 mL and blood transfusion was performed during the operation. The remaining 9 patients had a blood loss of 100-600 mL and an average volume of 260 ± 314 mL, with no blood transfusion. The postoperative gastrointestinal function recovery time was 1 ~ 8 days (mean, 3.6 ± 4.2 days). Patients recovered well after surgery, no urinary fistula, intestinal fistula and other complications. Within 1 week after surgery, ileum bladder indwelling double lumen catheter was removed to collect urine. After 4 weeks, the single J tube was removed. The follow-up time ranged from 3 to 6 months. The renal function of the patients remained normal. No renal hydronephrosis, chest CT and pelvic CT were detected by B-ultrasound , The tumor did not appear recurrence and metastasis. Conclusions Laparoscopic radical cystectomy + ileum bladder surgery is a safe and effective surgical method for bladder cancer patients with good curative effect, less trauma, less bleeding and faster postoperative recovery. It is worth further study and application.