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目的:探讨经腹膜外途径行腹腔镜膀胱全切术的手术方法和临床效果。方法:选取2013年1月~2014年8月收治的6例T_2期的肌层浸润性膀胱癌男性患者。年龄54~80岁,平均71.6岁。建立腹膜外腔隙后参照开放手术顺行膀胱切除法行腹腔镜根治性膀胱切除。尿流改道其中3例行双侧输尿管皮肤造口术,1例行原位新膀胱,2例行Brick回肠膀胱术。结果:6例患者均手术成功,无中转开放。根治性膀胱切除手术时间120~200 min,平均1 36.7 min。术中出血量100~350 ml,平均210 ml。术后平均住院时间7~16 d。术后随访3~18个月,肾功能均正常,未见局部复发或转移。结论:根据初期的手术操作经验和随访结果,经腹膜外途径腹腔镜膀胱全切术在临床上具有良好的可行性和安全性。
Objective: To investigate the surgical method and clinical effect of laparoscopic total hysterectomy via extraperitoneal route. Methods: Six patients with T 2 stage myometrial invasive bladder cancer admitted to our hospital from January 2013 to August 2014 were enrolled. Age 54 to 80 years old, average 71.6 years old. The establishment of extraperitoneal space after open surgery in line with radical cystectomy laparoscopic radical cystectomy. Urinary diversion in which 3 cases of bilateral ureteral skin ostomy, a routine in situ neobladder, 2 cases of Brick Iliac bladder surgery. Results: All the 6 patients were successful in operation and no transit was found. Radical cystectomy operation time 120 ~ 200 min, an average of 1 36.7 min. Intraoperative blood loss of 100 ~ 350 ml, an average of 210 ml. The average postoperative hospital stay was 7-16 days. All the patients were followed up for 3-18 months and their renal function were normal. No local recurrence or metastasis was found. Conclusion: According to the initial operation experience and follow-up results, laparoscopic total hysterectomy via the extraperitoneal route has good clinical feasibility and safety.