论文部分内容阅读
目的:比较278例腹腔镜根治性膀胱切除原位膀胱术及176例开放手术患者手术并发症及肿瘤学结果。方法:回顾分析我院2007~2014年间行腹腔镜根治性膀胱切除原位膀胱术患者及开放手术患者,对主要围手术期相关、术后早期(<90d)并发症、晚期(>90d)并发症、术后肿瘤控制结局进行比较。结果:术中出血量及输血率、术后留置盆腔引流管时间、术后住院时间等方面腹腔镜根治性膀胱切除术组与开放手术相比较有明显的优势,术后胃肠通气时间两者没有明显差异,而平均手术时间开放手术组短于腹腔镜手术组;两组术后早期(<90d)并发症发生率的差异有统计学意义(腹腔镜组46.0%,开放组61.4%,P<0.01),晚期(>90d)并发症发生率差异无统计学意义(腹腔镜组15.1%,开放组17.6%,P=0.513);术后36个月复发率(腹腔镜组7.6%,开放组8.5%,P=0.724),总体生存率(腹腔镜组80.6%,开放组83.5%,P=0.457)的差异无统计学意义。结论:腹腔镜膀胱根治性切除原位膀胱术与开放手术相比,早期并发症的发生率稍低,而晚期并发症及术后肿瘤控制情况无明显差异。
OBJECTIVE: To compare the surgical complications and oncology outcomes of 278 cases of laparoscopic radical cystectomy in situ and 176 cases of open surgery. Methods: The patients undergoing laparoscopic radical cystectomy and open surgery in our hospital from 2007 to 2014 were retrospectively analyzed. The main perioperative period, early postoperative (<90d) complication, late postoperative (> 90d) Symptoms, postoperative tumor control outcomes were compared. Results: Laparoscopic radical cystectomy was significantly superior to open surgery in terms of intraoperative blood loss and transfusion rate, postoperative pelvic drainage tube placement, postoperative hospital stay, etc. Both postoperative gastrointestinal ventilation duration There was no significant difference between the two groups (P> 0.05). The mean operative time was shorter in the open surgery group than in the laparoscopic surgery group. There was significant difference in the incidence of complications between the two groups (<90 days) (laparoscopic group 46.0%, open group 61.4%, P (P <0.01). There was no significant difference in the incidence of complications in the advanced stage (> 90 days) (laparoscopic group 15.1%, open group 17.6%, P = 0.513) Group 8.5%, P = 0.724). There was no significant difference in overall survival (80.6% in laparoscopic group, 83.5% in open group, P = 0.457). Conclusions: Compared with open surgery, laparoscopic radical cystectomy in situ bladder surgery has a lower incidence of early complications and no significant difference in late complications and postoperative tumor control.