腹腔镜根治性膀胱切除术
Laparoscopic radical cystectomy.
作者信息
Fergany Amr
机构信息
Glickman Urological and Kidney Institute, Cleveland Clinic Q-10, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
出版信息
Arab J Urol. 2012 Mar;10(1):40-5. doi: 10.1016/j.aju.2012.01.003. Epub 2012 Feb 20.
OBJECTIVE
Laparoscopic radical cystectomy (LRC) has emerged as a minimally invasive alternative to open radical cystectomy (ORC). This review focuses on patient selection criteria, technical aspects and postoperative outcomes of LRC.
METHODS
Material for the review was obtained by a PubMed search over the last 10 years, using the keywords 'laparoscopic radical cystectomy' and 'laparoscopic bladder cancer' in human subjects.
RESULTS
Twenty-two publications selected for relevance and content were used for this review from the total search yield. The level of evidence was IIb and III. LRC results in comparable short- and intermediate-range oncological outcomes to ORC, with generally longer operative times but decreased blood loss, postoperative pain and hospital stay. Overall operative and postoperative morbidity are equivalent.
CONCLUSION
In experienced hands, LRC is an acceptable minimally invasive alternative to ORC in selected patients, with the main advantage of decreased blood loss and postoperative pain, as well as a shorter hospital stay and recovery.
目的
腹腔镜根治性膀胱切除术（LRC）已成为开放性根治性膀胱切除术（ORC）的一种微创替代方法。本综述聚焦于LRC的患者选择标准、技术要点及术后结果。
方法
通过在过去10年的PubMed数据库中检索，使用关键词“腹腔镜根治性膀胱切除术”和“腹腔镜膀胱癌”检索人类受试者相关资料，以此获取本综述的素材。
结果
从全部检索结果中筛选出22篇与主题相关且内容合适的文献用于本综述。证据级别为IIb和III级。LRC在短期和中期肿瘤学结果方面与ORC相当，手术时间通常更长，但失血量减少，术后疼痛减轻，住院时间缩短。总体手术及术后并发症发生率相当。
结论
在经验丰富的医生手中，对于选定的患者，LRC是一种可接受的ORC微创替代方法，其主要优点是失血量减少、术后疼痛减轻、住院时间缩短及恢复更快。
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