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目的探讨复杂的根治性膀胱切除术采用手辅式腹腔镜治疗临床效果。方法本次观察组选取20例复杂的根治性膀胱切除术患者作研究对象,均为本院2012年9月~2013年9月收治,采用手辅式腹腔镜治疗,就临床情况与同期收治的纯腹腔镜根治性膀胱切除术对照组20例效果进行比较。结果观察组平均手术时间长于对照组,失血量高于对照组,但两组平均住院时间比较差异无统计学意义(P>0.05)。两组切口感染各1例,无复发病例,在并发症及复发率方面比较差异无统计学意义(P>0.05)。结论腹腔镜根治性膀胱切除术具有一定的可行性和安全性,但对于肿瘤分期较高、体积大对膀胱显露造成影响,肥胖和术前有盆腔手术史的患者,需考虑应用手辅助式腹腔镜手术,以避免创伤并发症,提高操作成功率。
Objective To investigate the clinical effect of hand-assisted laparoscopy in complicated radical cystectomy. Methods Twenty cases of complicated radical cystectomy were selected as study subjects in this study. All of them were treated in our hospital from September 2012 to September 2013. They were treated with hand-assisted laparoscopy. The clinical data were compared with those of the same period Pure laparoscopic radical cystectomy in the control group, the effect of 20 cases were compared. Results The average operation time of the observation group was longer than that of the control group, and the blood loss was higher than that of the control group. There was no significant difference between the two groups in the average length of stay (P> 0.05). There was no significant difference in complications and recurrence between the two groups (1 case, no recurrence) (P> 0.05). Conclusion Laparoscopic radical cystectomy has a certain feasibility and safety, but for patients with high tumor stage, bulky bladder exposure, obesity and preoperative pelvic surgery history, the need to consider the use of hand-assisted abdominal cavity Mirror surgery to avoid traumatic complications and improve the success rate of operation.