Guillotreau Julien, Gamé Xavier, Mouzin Marc, Doumerc Nicolas, Mallet Richard, Sallusto Federico, Malavaud Bernard, Rischmann Pascal
Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, Toulouse, France.
J Urol. 2009 Feb;181(2):554-9; discussion 559. doi: 10.1016/j.juro.2008.10.011. Epub 2008 Dec 13.
We compared the morbidity and mortality of laparoscopic vs open surgery in radical cystectomy for bladder cancer.
This prospective, nonrandomized study was conducted between January 2003 and July 2007 in 68 patients (7 women and 61 men) who underwent radical cystectomy for bladder cancer. A total of 38 cystectomies were performed laparoscopically and 30 by open surgery. Mean patient age was 68.0 +/- 9.0 years. Median preoperative American Society of Anesthesiologists score was 2 (range 1 to 3) in both groups.
Intraoperative blood loss and transfusion rate were significantly lower in the laparoscopic surgery group. Postoperatively the incidence of minor complications and mortality were also significantly lower. Postoperative opioid consumption was significantly less in the laparoscopic surgery group in amount and duration. Resumption of oral fluid and solid intake as well as return to normal bowel function were significantly more rapid in the laparoscopic surgery group, and mean hospital stay was significantly shorter. Mean patient followup was 30.5 +/- 17.2 months.
Laparoscopic radical cystectomy for bladder cancer has a lower morbidity rate than cystectomy by open surgery. It allows more rapid resumption of oral fluid and solid intake as well as return to normal bowel function and shorter hospital stay.
我们比较了腹腔镜与开放手术在膀胱癌根治性膀胱切除术中的发病率和死亡率。
这项前瞻性、非随机研究于2003年1月至2007年7月期间对68例接受膀胱癌根治性膀胱切除术的患者（7名女性和61名男性）进行。共进行了38例腹腔镜膀胱切除术和30例开放手术。患者平均年龄为68.0±9.0岁。两组患者术前美国麻醉医师协会评分中位数均为2（范围1至3）。
腹腔镜手术组术中失血量和输血率显著较低。术后轻微并发症发生率和死亡率也显著较低。腹腔镜手术组术后阿片类药物消耗量在数量和持续时间上均显著较少。腹腔镜手术组口服液体和固体食物的恢复以及肠道功能恢复正常明显更快，平均住院时间显著更短。患者平均随访时间为30.5±17.2个月。
腹腔镜膀胱癌根治性膀胱切除术的发病率低于开放手术膀胱切除术。它能使口服液体和固体食物更快恢复，肠道功能更快恢复正常，住院时间更短。
