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全腹腔镜根治性膀胱切除术并乙状结肠直肠膀胱术（美因茨Ⅱ型膀胱术）的技术与结果——初步经验

Technique and results in total laparoscopic radical cystectomy with sigmoidorectal pouch (Mainz pouch II) - an initial experience.

作者信息

Bao Junsheng, Yue Zhongjin, Wu Gongjin, Shi Wei, Wang Wei

机构信息

Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu 730030, P.R. China.

出版信息

Exp Ther Med. 2017 May;13(5):1749-1752. doi: 10.3892/etm.2017.4163. Epub 2017 Feb 24.

DOI:10.3892/etm.2017.4163
PMID:28565762
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5443313/
Abstract

We used laparoscopic radical cystectomy (LRC) with urinary diversion for muscle-invasive bladder cancer. A series of total LRC is presented with Mainz pouch II after we had gained experience of nearly 200 open radical cystectomy and 23 LRC. Since from October 2010 to April 2012, we performed totally LRC in 5 patients with muscle-invasive bladder cancer with Mainz pouch II as a urinary diversion. We analyzed age, pathological staging, continence, operative time, blood loss, blood transfusion volume, and complications. The mean age of the patients was 58.8±7.6 years (range, 49-69 years), and the follow-up time was 15.4±4.72 months. The mean operative time was 577.0±126.4 min for total LRC, with a mean blood loss of 280.0±130.38 ml and a mean hospital stay of 29.4±9.2 days. Blood transfusion was required in two cases, and immediate and late complications were observed in 2 cases. In conclusion, total LRC with urinary diversion is feasible for the management of muscle-invasive bladder cancer, by experienced surgeons, and despite the high level of difficulty of these procedures.

摘要

我们采用腹腔镜根治性膀胱切除术（LRC）联合尿流改道术治疗肌层浸润性膀胱癌。在积累了近200例开放性根治性膀胱切除术和23例LRC的经验后，我们展示了一系列采用Mainz II型肠袋的全腹腔镜根治性膀胱切除术。自2010年10月至2012年4月，我们对5例肌层浸润性膀胱癌患者实施了全腹腔镜根治性膀胱切除术，并采用Mainz II型肠袋进行尿流改道。我们分析了患者的年龄、病理分期、控尿情况、手术时间、失血量、输血量及并发症。患者的平均年龄为58.8±7.6岁（范围49 - 69岁），随访时间为15.4±4.72个月。全腹腔镜根治性膀胱切除术的平均手术时间为577.0±126.4分钟，平均失血量为280.0±130.38毫升，平均住院时间为29.4±9.2天。2例患者需要输血，2例患者出现了近期和远期并发症。总之，对于肌层浸润性膀胱癌的治疗，经验丰富的外科医生实施全腹腔镜根治性膀胱切除术联合尿流改道术是可行的，尽管这些手术难度较大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/50d6c2c6225a/etm-13-05-1749-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/608241096f91/etm-13-05-1749-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/c5dd15b62232/etm-13-05-1749-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/2151fbe8b12d/etm-13-05-1749-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/4e8940c9a10c/etm-13-05-1749-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/50d6c2c6225a/etm-13-05-1749-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/608241096f91/etm-13-05-1749-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/c5dd15b62232/etm-13-05-1749-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/2151fbe8b12d/etm-13-05-1749-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/4e8940c9a10c/etm-13-05-1749-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/339f/5443313/50d6c2c6225a/etm-13-05-1749-g04.jpg

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