腹腔镜根治性膀胱切除术加原位回肠新膀胱术治疗膀胱癌的远期预后疗效探讨
|
摘要
目的探究分析腹腔镜根治性膀胱切除术加原位回肠新膀胱术治疗膀胱癌的远期预后疗效。方法从2016年1月—2018年1月该院收治的膀胱癌患者中抽选65例,根据患者接受手术的不同分为两组。实验组33例,采取腹腔镜根治性膀胱切除术加原位回肠新膀胱术治疗,对照组32例,采取开放性膀胱切除术加原位回肠新膀胱术治疗,对比两组患者远期预后疗效。结果两组手术时间差异无统计学意(t=1.153 3,P=0.253);实验组术中出血量、胃肠功能恢复情况、住院时间等均明显少于对照组(t=60.987 9、13.401 3、13.001 2,P=0.000、0.000、0.000),且实验组术后六个月复发率(3.03%)明显低于对照组(21.88%),差异有统计学意义(χ~2=5.345 5,P=0.021)。结论在膀胱癌患者中采取腹腔镜根治性膀胱切除术加原位回肠新膀胱术治疗远期预后良好,手术过程中,出血量少、对患者的创伤小,能够快速恢复患者胃肠功能,值得推广应用。
Objective To investigate the long-term prognosis of laparoscopic radical cystectomy combined with ileal neobladder in the treatment of bladder cancer. Methods From January 2016 to January 2018, 65 patients with bladder cancer were enrolled in our hospital. They were divided into two groups according to the patients undergoing surgery.33 patients in the experimental group were treated with laparoscopic radical cystectomy plus orthotopic ileal neobladder. 32 patients in the control group were treated with open cystectomy plus orthotopic ileal neobladder. The long-term prognosis of the two groups was compared. Results There was no significant difference in operation time between the two groups. The difference was not statistically significant(t=1.153 3, P=0.253). The amount of bleeding, gastrointestinal function recovery, and hospitalization time in the experimental group were significantly less than those in the control group(t=60.9879, 13.401 3, 13.001 2, P=0.000, 0.000, 0.000), and the recurrence rate(3.03%) of the experimental group was significantly lower than that of the control group(21.88%), the difference was statistically significant(χ~2=5.345 5, P=0.021). Conclusion Laparoscopic radical cystectomy combined with ileal neobladder in patients with bladder cancer has a good long-term prognosis. During the operation, the amount of bleeding is small, the trauma to the patient is small, and the gastrointestinal function can be quickly restored. It is worth promoting.
Objective To investigate the long-term prognosis of laparoscopic radical cystectomy combined with ileal neobladder in the treatment of bladder cancer. Methods From January 2016 to January 2018, 65 patients with bladder cancer were enrolled in our hospital. They were divided into two groups according to the patients undergoing surgery.33 patients in the experimental group were treated with laparoscopic radical cystectomy plus orthotopic ileal neobladder. 32 patients in the control group were treated with open cystectomy plus orthotopic ileal neobladder. The long-term prognosis of the two groups was compared. Results There was no significant difference in operation time between the two groups. The difference was not statistically significant(t=1.153 3, P=0.253). The amount of bleeding, gastrointestinal function recovery, and hospitalization time in the experimental group were significantly less than those in the control group(t=60.9879, 13.401 3, 13.001 2, P=0.000, 0.000, 0.000), and the recurrence rate(3.03%) of the experimental group was significantly lower than that of the control group(21.88%), the difference was statistically significant(χ~2=5.345 5, P=0.021). Conclusion Laparoscopic radical cystectomy combined with ileal neobladder in patients with bladder cancer has a good long-term prognosis. During the operation, the amount of bleeding is small, the trauma to the patient is small, and the gastrointestinal function can be quickly restored. It is worth promoting.
引文
[1]肖永双,陈家存,李望,等.完全腹腔镜下根治性全膀胱切除加原位U形回肠新膀胱术治疗膀胱癌的临床效果(附8例报告)[J].徐州医学院学报,2017,37(9):580-583.
[2]梁天才,王敏,梁国标,等.腹腔镜根治性膀胱全切+原位回肠新膀胱术治疗浸润性膀胱癌[J].中国内镜杂志2017,23(1):74-79.
[3]吴岑,苏仲宁,伍伯聪,等.腹腔镜根治性全膀胱切除+原位回肠新膀胱术对膀胱癌患者的临床疗效及并发症分析[J].国际泌尿系统杂志,2016,36(4):481-484.
[4]常德辉,王养民,张伟君,等.腹腔镜根治性膀胱切除+回肠原位新膀胱术疗效分析[J].现代肿瘤医学,2017,25(5)765-768.
[5]刘赛,瓦斯里江·瓦哈甫,牛亦农,等.完全3D腹腔镜下根治性膀胱切除加尿流改道术的早期经验与探讨[J].中华泌尿外科杂志,2016,37(6):461-464.
[6]刘锋,王帅,祁小龙,等.完全腹腔镜下根治性膀胱切除及原位U形回肠新膀胱术19例报告[J].临床泌尿外科杂志,2016,36(5):412-414.
[7]刘金秀,雷荣兰,张艳梅,等.排尿方式干预在根治性膀胱全切除原位回肠新膀胱术患者出院指导中的应用[J].护士进修杂志,2017,32(1):53-55.
[8]于春虎,田野,成海生,等.两种不同手术方式处理输尿管末端治疗上尿路肿瘤远期疗效比较[J].现代生物医学进展,2016,16(17):3276-3278.
[9]齐振阳.经尿道膀胱肿瘤二次电切术治疗膀胱癌的复发及预后观察[J].中国实用医药,2016,11(5):117-118.
[10]李文永,李庆文,汪盛,等.腹腔镜根治性膀胱切除+原位回肠新膀胱术治疗浸润性膀胱癌的临床疗效分析[J]现代肿瘤医学,2017,25(21):3448-3451.
[2]梁天才,王敏,梁国标,等.腹腔镜根治性膀胱全切+原位回肠新膀胱术治疗浸润性膀胱癌[J].中国内镜杂志2017,23(1):74-79.
[3]吴岑,苏仲宁,伍伯聪,等.腹腔镜根治性全膀胱切除+原位回肠新膀胱术对膀胱癌患者的临床疗效及并发症分析[J].国际泌尿系统杂志,2016,36(4):481-484.
[4]常德辉,王养民,张伟君,等.腹腔镜根治性膀胱切除+回肠原位新膀胱术疗效分析[J].现代肿瘤医学,2017,25(5)765-768.
[5]刘赛,瓦斯里江·瓦哈甫,牛亦农,等.完全3D腹腔镜下根治性膀胱切除加尿流改道术的早期经验与探讨[J].中华泌尿外科杂志,2016,37(6):461-464.
[6]刘锋,王帅,祁小龙,等.完全腹腔镜下根治性膀胱切除及原位U形回肠新膀胱术19例报告[J].临床泌尿外科杂志,2016,36(5):412-414.
[7]刘金秀,雷荣兰,张艳梅,等.排尿方式干预在根治性膀胱全切除原位回肠新膀胱术患者出院指导中的应用[J].护士进修杂志,2017,32(1):53-55.
[8]于春虎,田野,成海生,等.两种不同手术方式处理输尿管末端治疗上尿路肿瘤远期疗效比较[J].现代生物医学进展,2016,16(17):3276-3278.
[9]齐振阳.经尿道膀胱肿瘤二次电切术治疗膀胱癌的复发及预后观察[J].中国实用医药,2016,11(5):117-118.
[10]李文永,李庆文,汪盛,等.腹腔镜根治性膀胱切除+原位回肠新膀胱术治疗浸润性膀胱癌的临床疗效分析[J]现代肿瘤医学,2017,25(21):3448-3451.