Xia Guo-wei, Ding Qiang, Xu Ke, Zhang Yuan-fang
Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.
Chin Med J (Engl). 2007 Jan 20;120(2):132-5.
We presented the technique and outcomes of laparoscopic radical cystectomy performed in 28 patients with bladder cancer to evaluate its clinical efficacy and feasibility.
Among the 28 patients, aged from 58 to 73 years (mean 68.5 years), 26 were transitional cell carcinoma grads II - III and 2 squamous carcinoma. Laparoscopic radical cystectomy plus bladder reconstruction was performed in all cases, among them 15 with ileum, 10 with rectum pouch, and 3 with ureterostomy. The operating time, the blood loss, the intestine function and the complications were observed.
All procedures were successful. The operating times were 7 - 10 hours, the blood loss was 400 - 1500 ml (mean 850 ml), the intestine function recovered at 72 hours after operation, and all ureteral catheters were removed at 2 weeks after surgery. The results of intravenous urography were normal at 3-month, 1-year, and 2-year follow-up after surgery.
Laparoscopic radical cystectomy for invasive bladder cancer is safe and efficient, with good operating field, reliable hemostasis, mini-invasion, less celiac complications, and rapid recovery. This surgery is worth being extended.
我们展示了对28例膀胱癌患者实施腹腔镜根治性膀胱切除术的技术及结果,以评估其临床疗效和可行性。
28例患者年龄在58至73岁之间(平均68.5岁),其中26例为II - III级移行细胞癌,2例为鳞状细胞癌。所有病例均行腹腔镜根治性膀胱切除术加膀胱重建术,其中15例采用回肠,10例采用直肠膀胱袋,3例采用输尿管造口术。观察手术时间、出血量、肠道功能及并发症情况。
所有手术均成功。手术时间为7至10小时,出血量为400至1500毫升(平均850毫升),术后72小时肠道功能恢复,术后2周拔除所有输尿管导管。术后3个月、1年及2年随访时静脉肾盂造影结果均正常。
腹腔镜根治性膀胱切除术治疗浸润性膀胱癌安全有效,手术视野良好,止血可靠,创伤小,腹腔并发症少,恢复快。该手术值得推广。