[1]董隽,高江平,张磊,等.腹腔镜下膀胱根治性切除术（附23例报告）[J].中国微创外科杂志,2008,08(3):253-254.
　Dong Jun,Gao Jiangping,Zhang Lei,et al.Laparoscopic Radical Cystectomy: Report of 23 Cases[J].Chinese Journal of Minimally Invasive Surgery,2008,08(3):253-254.
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腹腔镜下膀胱根治性切除术（附23例报告）()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年3期
页码:
253-254
栏目:
出版日期:
2008-10-25

文章信息/Info

Title:
Laparoscopic Radical Cystectomy: Report of 23 Cases
作者:
董隽; 高江平; 张磊; 王威; 徐阿祥; 史立新; 朱捷; 郭刚; 洪宝发
解放军总医院泌尿外科,北京100853
Author(s):
Dong Jun;  Gao Jiangping;  Zhang Lei;  et al.
Department of Urology, General Hospital of PLA, Beijing 100853, China.
关键词:
膀胱肿瘤; 腹腔镜; 全膀胱切除术; 尿流改道
Keywords:
Bladder neoplasm; Laparoscopy; Radical cystectomy; Urinary diversion surgery
分类号:
R737.14
文献标志码:
A
摘要:
目的探讨腹腔镜下膀胱根治性切除术的手术方法和临床效果。方法浸润性膀胱癌23例，无远处转移，采用5个trocar，腹腔镜下行膀胱根治性切除术、前列腺切除，下腹正中做7 cm切口，取出切除的膀胱、前列腺，尿流改道方式包括17例回肠膀胱术、3例回肠代膀胱术、1例输尿管乙状结肠吻合、2例输尿管皮肤造口。结果手术时间4~10 h，平均7.5 h。出血量100~800 ml，平均311 ml，1例输血1000 ml，余22例未输血。术后2例麻痹性肠梗阻，经保守治疗痊愈，无其他并发症。术后随访2~32个月，2例因远处转移死亡，21例健在，无瘤生存2~32个月，平均17个月，肾功能正常，B超及IVU检查1例轻度双肾积水。结论 腹腔镜下膀胱根治性切除术安全可行，创伤小，出血少，恢复快。
Abstract:
ObjectiveTo study the technique and outcomes of laparoscopic radical cystectomy (LRC).MethodsA total of 23 patients with bladder cancer including 22 men and 1 women were enrolled in this study. The mean age of the patients was 61 years (ranged 50-74). No distant metastasis was found in the cases. LRC was performed using 5 trocars. After the prostate was resected, a 7cm middle abdominal incision was made and the bladder and prostate were removed. Afterwards, the patients received urinary diversion surgery including ileal conduit urinary diversion in 17, orthotopic ileal neobladder in 3, sigmoid ureterostomy in 1, and cutaneous ureterostomy in 2.ResultsThe mean operation time was 7.5 h (ranged 4 to 10) and mean blood loss was 311 ml (100 to 800). One of the patients received blood transfusion (1000 ml) during the operation. Two patients developed paralytic bowel obstruction and was cured by conservative therapy without showing other complications. The patients were followed up for 2 to 32 months with a mean of 17 months, during which 2 died of distant metastasis and 21 survived without tumor recurrence. The patient had normal renal functions after the operation. Bultrasonography and IVU showed mild hydronephrosis in one patient.ConclusionsLRC is a promising method for the treatment of bladder cancer. Patients with such a disease have less trauma, less blood loss, and quicker recovery by treating with the method.

参考文献/References:

[1]黄健，姚友生，许可慰，等.腹腔镜下膀胱根治性切除术原位回肠代膀胱术（附15例报告）.中华泌尿外科杂志，2004，25(3)：175-179.
[2]Parra RO,Andrus CH,Jones JP,et al.Laparoscopic cystectomy:initial report on a new treatment for the retained bladder.J Urol,1992,148(4):1140-1144.
[3]Sanchez de Badajoz E,Gallego Perales JL,Reche Rosado A,et al.Laparoscopic cystectomy and ideal conduit: case report.J Endourol,1995,9(1):59-62.
[4]Guillonneau B,Cathelineau X,Doublet JD,et al.Laparoscopic radical prostatectomy:assessment after 550 procedures.Crit Rev Oncol Hematol,2002,43(2):123-133.
[5]罗康平，马潞林，黄毅，等.后腹腔镜根治性肾切除术126例报告.中国微创外科杂志，2007，7（3）：245-246.
[6]Haber GP,Colombo JR,Aron M,et al.Laparoscopic radical cystectomy and urinary diversion: status in 2006.Eur Urol Suppl,2006,5:950-955.
[7]Gaston R,Barmoshe S,Pansadoro A,et al.Laparoscopic radical cystectomy:Review of 100 cases.Eur Urol Suppl,2006,5:23.
[8]Gill IS,Kaouk JH,Meraney AM,et al.Laparoscopic radical cystectomy and continent orthotopic ileal neobladder performed completely intracorporeally:the initial experience.J Urol,2002,168(1):13-18.
[9]Garboardi F,Simonato A,Galli S,et al.Minimally invasive laparoscopic neobladder.J Urol,2002,168(3):1080-1083.
[10]Gerullis H,Kuemmel C,Popken G.Laparoscopic cystectomy with extracorporealassisted urinary diversion:experience with 34 patients.Eur Urol,2007,51:193-198.
[11]Cathelineau X,Arroyo C,Rozet F,et al.Laparoscopic assisted radical cystectomy:the Montsouris experience after 84 cases.Eur Urol,2005,47:780-784.
[12]Basillote JB,Abdelshehid C,Ahlering TE,et al.Laparoscopic assisted radical cystectomy with ileal neobladder:a comparison with the open approach.J Urol,2004, 172(2):489-493.
[13]Cathelineau X,Jaffe J.Laparoscopic radical cystectomy with urinary diversion: what is the optimal technique?Curr Opin Urol,2007,17:93-97.

更新日期/Last Update: 2013-10-22