本文選題：腹腔鏡 + 膀胱癌��； 參考：《重慶醫(yī)學》2017年01期

【摘要】：目的探討單中心腹腔鏡下根治性膀胱切除術治療膀胱癌安全性及腫瘤控制的效果。方法選擇2009年9月至2015年9月本中心所行腹腔鏡下根治性膀胱切除、尿流改道術患者53例,收集臨床病理資料,并對術后并發(fā)癥及生存情況進行隨訪,運用Kaplan-Meier法分析生存數(shù)據(jù),得出術后3年的生存率。結果所有手術均成功在腹腔鏡下完成,平均手術時間(417±111)min,平均出血量(491±355)mL,輸血率34.0%,術后平均住院時間為(21.1±9.6)d。近期并發(fā)癥發(fā)生率37.7%(20/53),遠期并發(fā)癥發(fā)生率22.6%(12/53)。本組病理多為尿路上皮癌(88.7%),其中高級別腫瘤占57.1%,浸潤性膀胱癌(T2期及以上)占77.4%。平均隨訪時間(24±19)個月,截至2015年12月,29例(54.7%)無瘤存活,3年總體生存率為57.0%,無復發(fā)生存率為72.0%,腫瘤特異性生存率為74.0%,亞組分析顯示70歲及以下比70歲以上者總體生存率高,非肌層浸潤性比肌層浸潤性膀胱癌總體生存率高。結論腹腔鏡下根治性膀胱切除術安全有效,中期隨訪結果顯示對腫瘤的控制滿意,與開放性手術具有可比性。
[Abstract]:Objective to evaluate the safety and tumor control of single-center laparoscopic radical cystectomy for bladder cancer. Methods from September 2009 to September 2015, 53 patients underwent laparoscopic radical cystectomy and urinary diversion were selected. The clinical and pathological data were collected, and the postoperative complications and survival conditions were followed up. Survival data were analyzed by Kaplan-Meier method. The 3-year survival rate was obtained. Results all the operations were successfully performed under laparoscopy. The mean operation time was 417 鹵111 minutes, the mean blood loss was 491 鹵355mL, the blood transfusion rate was 34.0 and the average hospital stay was 21.1 鹵9.6 days. The incidence of short term complications was 37. 7% 20 / 53 and 22. 6% / 53%. Most of the cases were urethral epithelial carcinoma (88.7%), including 57.1% of high grade tumors and 77.4% of invasive bladder carcinoma at T2 stage and above. The mean follow-up time was 24 鹵19 months. As of December 2015, 29 patients (54.74.7a) survived without tumor. The overall 3-year survival rate was 57.0, the recurrence free survival rate was 72.0, and the tumor-specific survival rate was 74.0. The subgroup analysis showed that the overall survival rate of patients aged 70 years and below was higher than that of those over 70 years old. The overall survival rate of non-myometrial invasive bladder cancer was higher than that of myometrial invasive bladder cancer. Conclusion Laparoscopic radical cystectomy is safe and effective. The results of mid-term follow-up show that the control of tumor is satisfactory and comparable with open operation.
【作者單位】： 四川省醫(yī)學科學院/四川省人民醫(yī)院泌尿外科;
【分類號】：R737.14

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