Chen Jiangang, Gu Zhibo, Pan Yongsheng, Zhang Yong, Gu Donghua
Department of Urology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China.
Evid Based Complement Alternat Med. 2022 Jul 4;2022:1681038. doi: 10.1155/2022/1681038. eCollection 2022.
Bladder cancer is a common malignant tumor of the urinary system in the clinic. It has multiple lesions, easy recurrence, easy metastasis, poor prognosis, and high mortality.
The aim of this study is to investigate the impact of laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC) on the surgical outcome, complications, and prognosis of elderly patients with bladder cancer.
One hundred elderly bladder cancer patients who underwent surgery in our hospital from June 2019 to June 2021 were selected for the retrospective study and were divided into 50 cases each in the ORC group and the LRC group according to the different surgical methods. The ORC group was treated with ORC, and the LRC group implemented LRC treatment. The differences in surgery, immune function, recent clinical outcomes, and complications between the two groups were observed and compared.
The mean operative time, mean intraoperative bleeding, intraoperative and postoperative transfusion rate, and transfusion volume of patients in the LRC group were statistically significant when compared to the ORC group. The differences in the meantime to resume eating, time to get out of bed, mean number of days in hospital after surgery, and the amount of postoperative numbing analgesics used by patients in the LRC group after surgery were statistically significant compared to the ORC group ( < 0.05). There was no statistically significant difference in the comparison of immune function between the two groups before surgery ( > 0.05), while the comparison of CD8 and B cells 1 week after surgery of the LRC group was significantly better than that of the ORC group ( < 0.05), and the operation time of the LRC group was longer than that of the ORC group ( < 0.05). Statistical analysis of postoperative complications showed that the overall incidence of postoperative complications in the LRC group was significantly lower than that in the ORC group (16.67% vs. 46.67%) ( < 0.05).
LRC has less surgical trauma and intraoperative bleeding, faster postoperative recovery, and fewer postoperative complications, providing some reference for clinical surgery for elderly bladder cancer patients.
膀胱癌是临床上常见的泌尿系统恶性肿瘤。它具有多病灶、易复发、易转移、预后差及死亡率高的特点。
本研究旨在探讨腹腔镜根治性膀胱切除术（LRC）与开放性根治性膀胱切除术（ORC）对老年膀胱癌患者手术效果、并发症及预后的影响。
选取2019年6月至2021年6月在我院接受手术的100例老年膀胱癌患者进行回顾性研究，根据手术方式不同分为ORC组和LRC组，每组50例。ORC组采用ORC治疗，LRC组实施LRC治疗。观察并比较两组手术情况、免疫功能、近期临床疗效及并发症的差异。
与ORC组相比，LRC组患者的平均手术时间、平均术中出血量、术中和术后输血率及输血量差异有统计学意义。LRC组患者术后恢复进食时间、下床时间、术后平均住院天数及术后使用麻醉性镇痛药的量与ORC组相比差异有统计学意义（P<0.05）。两组术前免疫功能比较差异无统计学意义（P>0.05），而LRC组术后1周CD8及B细胞的比较明显优于ORC组（P<0.05），且LRC组手术时间长于ORC组（P<0.05）。术后并发症统计分析显示，LRC组术后并发症总发生率明显低于ORC组（16.67%对46.67%）（P<0.05）。
LRC手术创伤小、术中出血少、术后恢复快、术后并发症少，为老年膀胱癌患者的临床手术提供了一定参考。
