腹腔镜与开放膀胱根治性切除一原位回肠新膀胱术的临床效果比较腹腔镜与开放膀胱根治性切除一原位回肠新膀胱术的临床效果比较［摘耍］目的比较腹腔镜与开放膀胱根治性切除-原位回肠新膀胱术治疗侵润性膀胱癌患者的临床效果。方法冋顾性分析该院自2009年1月一2012年6月收治的36例侵润性膀胱癌患者的临床资料,按照不同术式分为腹腔镜组(n=16)和开放手术组(n=20)o比较两组患者围手术期情况、术后并发症和术后1年的膀胱功能。结果观察组手术时间明显长于对照组［(366.8±42.5)minvs(308.4±38.2)min］,而术中出血量［(482・3±23.5)mLvs(1078.3±344.6)mL］和术后住院时间［(22.8±3.7)dvs(28・6±4・9)d］均明显小于对照组，差异有统计学意义(P<0.05)o观察组术后并发症明显少于对照组，差异有统计学意义(P〈0・05)；而两组患者术后1年的膀胱容量、膀胱内压和残余尿差异无统计学意义(P〉0・05)。结论腹腔镜下膀胱根治性切除术-原位回肠新膀胱术对机体损伤小、术后恢复快和并发症较少的优点，且术后膀胱功能与开放手术相当，是一种值得推广应用的术式。［关键词］腹腔镜；开放手术；膀胱根治性切除；原位回肠新膀胱术；效果［中图分类号］R737.14［文献标识码］A［文章编号］1674-0742(2014)05(a)-0034-02［Abstract］ObjectiveTocomparetheclinicaleffectof1aparoscopicandopenradicalresectionofbladderinsituileumnewbladdersurgeryforthetreatmentofpatientswithinvasivebladdercancer・MethodsTheclinicaldataof36patientswithinvasivebladdercanceradmittedinourhospitaifromJanuary,2009toJune,2012wereretrospectiveanalyzed・Andtheyweredividedinto1aparoscopicgroup(observationgroup,n=16)andopensurgicalgroup(controlgroup,n=20)accordingtothedifferentoperation.Theperioperativestatusandpostoperativecomplicationsandbladderfunction1yearaftertheoperationwerecomparedbetweenthetwogroups・ResultsTheoperationtimeoftheobservationgroupwassignificantlylongerthanthatofthecontrolgroup[(366.8+42.5)minvs(308.4+38.2)min],whiletheintraoperatvebloodloss[(482.3±23.5)mlvs(1078.3+344.6)ml]andlengthofstay[(22.8±3.7)dvs(28.6±4.9)d]weresmallerthanthoseofthecontrolgroup,thedifferenceswerestatisticallysignificant(allP〈0・05)・Thepostoperativecomplicationsoftheobservationgroupwasobviouslylessthanthoseofthecontrolgroup,thedifferencewasstatisticallysignificant(P<0.05)；andthedifferencesinbladdercapacity,intravesicalpressureandresidualurineinbladder1yearaftertheoperationbetweenthetwogroupswerenotstatisticallysignificant(allP〉0・05)・ConclusionLaparoscopicradicalresectionofbladderinsituileumnewbladdersurgeryhastheadvantagesofcausingminimaldamagetothebody,postoperativerecoverfaster,fewercomplications,andthepostoperativebladderfunctionisequivalenttothatoftheopenoperation,whichisworthyofpopularizationandapplication.[Keywords]Laparoscope；Openoperation；Radicalresectionofbladder；Insituileumnewbladdersurgery；Effect膀胱癌是泌尿系统最为常见的肿瘤之…，其发病率近年来呈现逐渐上升趋势[1]。根治性膀胱全切术是治疗侵润性膀胱癌的首选治疗方案，术后均需要进行尿流改道。传统的回场流出道术式是一种不可控性尿流改道，术后需要永久腹壁造口并外接集尿装置，对患者造成极大的心理压力[2]。原位回肠新膀胱手术是近年来新兴的一种尿流改道手术，不需要使用外接集尿装置，容易被患者接受[3]。为比较腹腔镜与开放膀胱根治性切除-原位回肠新膀胱术治疗侵润性膀胱癌患者的临床效果。现分析2009年1月一2012年6月间该院收治的36例侵润性膀胱癌患者的临床资料,现报道如下。