腹腔镜下膀胱部分切除术治疗膀胱憩室
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摘要
目的总结腹腔镜下膀胱部分切除术治疗膀胱憩室临床疗效并探讨其应用价值。方法回顾性分析2014年1月~2015年10月我科5例腹腔镜下膀胱部分切除术病例,4例行经尿道前列腺剜除术+腹腔镜下膀胱部分切除术,1例行经尿道膀胱颈切开术+腹腔镜下膀胱部分切除术。结果 5例患者手术均成功,平均手术时间140±23.7 min,平均出血量65±15.2 m L,无需输血,术中、术后未出现严重并发症,术后2~3d拔除引流管,平均住院时间7.4±1.1d。结论对于膀胱出口梗阻合并膀胱憩室病例,行经尿道电切术+腹腔镜下膀胱部分切除术,具有创伤小、出血少、恢复快、并发症少、住院时间短等优点,是微创治疗膀胱憩室安全、可行的手术方法。
Objective To assess the clinical efficacy of laparoscopic partial bladder resection in the treatment of bladder diverticulum and to explore the application value of it. Methods Retrospective analysis was applied to analysis cases who were given laparoscopic partial bladder resection from January 2014 to October 2015. Four cases were given transurethral enucleativeresection of the prostate and laparoscopic partial bladder resection, 1 case was underwent transurethral bladder neck incision surgery and laparoscopic partial bladder resection. Results The surgeries were successful in 5 cases. The average operation time was 140 ± 23.7 min, with average bleeding volume of 65 ± 15.2 m L. There was no need of blood transfusion.There were no serious complications after the operation. The drainage tube was removed 3 d later after operation. The average hospitalization time was 7.4 ± 1.1 d. Conclusion For bladder outlet obstruction(BOO) cases complicated with bladder diverticulum, transurethral enucleativeresection of the prostate(TUERP) and laparoscopic partial bladder resection showed the advantages of less trauma, less bleeding, quick recovery, fewer complications, less hospitalization. microinvasive treatment of bladder diverticulum is a safe and feasible operation method.
Objective To assess the clinical efficacy of laparoscopic partial bladder resection in the treatment of bladder diverticulum and to explore the application value of it. Methods Retrospective analysis was applied to analysis cases who were given laparoscopic partial bladder resection from January 2014 to October 2015. Four cases were given transurethral enucleativeresection of the prostate and laparoscopic partial bladder resection, 1 case was underwent transurethral bladder neck incision surgery and laparoscopic partial bladder resection. Results The surgeries were successful in 5 cases. The average operation time was 140 ± 23.7 min, with average bleeding volume of 65 ± 15.2 m L. There was no need of blood transfusion.There were no serious complications after the operation. The drainage tube was removed 3 d later after operation. The average hospitalization time was 7.4 ± 1.1 d. Conclusion For bladder outlet obstruction(BOO) cases complicated with bladder diverticulum, transurethral enucleativeresection of the prostate(TUERP) and laparoscopic partial bladder resection showed the advantages of less trauma, less bleeding, quick recovery, fewer complications, less hospitalization. microinvasive treatment of bladder diverticulum is a safe and feasible operation method.
引文
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[13]周海永,汪凯,孙吉,等.腹腔镜经腹腔膀胱憩室切除术的临床应用[J].浙江医学,2014,36(5):418-20.
[14]王雄海,韦躜.气膀胱腹腔镜手术的临床应用[J].中外健康文摘,2013,34(31):279-83.
[15]施卫国,董坚.经腹膜外途径腹腔镜下膀胱憩室切除术[J].国际泌尿系统杂志,2015,35(1):91-2.
[16]张翼飞,梁朝朝,江长琴,等.气膀胱腹腔镜切除膀胱憩室1例[J].安徽医学,2015,12(9):1173-4.
[17]陶洪飞,花增荣,高海波.膀胱憩室癌五例临床分析[J].海南医学,2011,22(21):59-60.
[2]Moreno SJ,Galante RI,Ortiz OE,et al.Bladder diverticulum robotic surgery:systematic review of case reports[J].Urol Int,2010,85(4):381-5.
[3]Eyraud R,Laydner H,Autorino R,et al.Robot-assisted laparoscopic bladder diverticulectomy[J].Curr Urol Rep,2013,14(1):46-51.
[4]Fox M,Power F,Bruce W.Diverticulum of the bladder-presentation and evaluation of treatment of 115 cases[J].Br J Urol,1962,34(6):286-98.
[5]Parra RO,Endocavitary BJ.Endocavitary(laparoscopic)bladder surgery[J].Semin Urol,1992,10(4):213-21.
[6]Bhojani N,Gandaglia G,Sood A,et al.Morbidity and mortality after benign prostatic hyperplasia surgery:data from the American College of Surgeons National surgical quality improvement program[J].J Endourol,2014,28(7):831-40.
[7]Health Quality Ontario.Energy delivery systems for treatment of benign prostatic hyperplasia:an evidence-based analysis[J].Ont Health Technol Assess Ser,2006,6(17):110-21.
[8]Vitale J,Woodside R.Management of bladder diverticula by transurethral resection:re-evaluation of an old technique[J].J Urol,1979,122(6):744-5.
[9]Clayman V,Shahin S,Reddy P,et al.Transurethral treatment of bladder diverticula,alternative to open diverticulectomy[J].Urology,1984,23(6):573-7.
[10]Antonio C,Zeccolini G,Guglielmo B.Laparoscopic extraperitoneal bladder diverticulectomy[J].J Endourology,2007,21(1):A282-6.
[11]Flasko T,Toth G,Benyo M,et al.A new technical approach for extraperitoneal laparoscopic bladder diverticulectomy[J].JLaparoendosc Adv Surg Tech A,2007,17(5):659-61.
[12]Servera A,Benejam J,Pons J,et al.Laparoscopic diverticulectomy:a systemised technique[J].Actas Urol Esp,2016,33(16):30062-6.
[13]周海永,汪凯,孙吉,等.腹腔镜经腹腔膀胱憩室切除术的临床应用[J].浙江医学,2014,36(5):418-20.
[14]王雄海,韦躜.气膀胱腹腔镜手术的临床应用[J].中外健康文摘,2013,34(31):279-83.
[15]施卫国,董坚.经腹膜外途径腹腔镜下膀胱憩室切除术[J].国际泌尿系统杂志,2015,35(1):91-2.
[16]张翼飞,梁朝朝,江长琴,等.气膀胱腹腔镜切除膀胱憩室1例[J].安徽医学,2015,12(9):1173-4.
[17]陶洪飞,花增荣,高海波.膀胱憩室癌五例临床分析[J].海南医学,2011,22(21):59-60.