本文選題：膀胱癌 + 肌層浸潤性膀胱癌�。� 參考：《山東醫(yī)藥》2017年15期

【摘要】：目的觀察經(jīng)腹膜外途徑行改良逆行膀胱全切術(shù)治療男性肌層浸潤性膀胱癌的效果。方法對18例男性T2期肌層浸潤性膀胱癌患者施行經(jīng)腹膜外改良逆行膀胱全切術(shù)。膀胱全切術(shù)后,4例行雙側(cè)輸尿管皮膚造口術(shù)、1例行原位回腸新膀胱術(shù)、13例行回腸膀胱術(shù)。記錄手術(shù)時間、術(shù)中出血量、術(shù)中輸血情況和腹腔臟器暴露時間。記錄術(shù)后盆腹腔引流管留置時間、通氣時間和住院時間。術(shù)后隨訪并發(fā)癥及局部復(fù)發(fā)和遠(yuǎn)處轉(zhuǎn)移情況。結(jié)果本組18例手術(shù)均獲得成功,手術(shù)時間145~310 min,術(shù)中出血量110~860 m L,術(shù)中輸血3例,術(shù)中腹腔臟器暴露時間0~65 min;盆腹腔引流時間5~14 d,術(shù)后通氣時間1~5 d,術(shù)后住院時間8~17 d。所有切除腫瘤組織切緣檢查均為陰性,2例術(shù)后盆腔淋巴結(jié)報告陽性,給予GC方案化療。術(shù)后無出血、周圍組織及臟器損傷和切口感染等并發(fā)癥發(fā)生。隨訪3~28個月,患者腎功能正常,未見局部復(fù)發(fā)及遠(yuǎn)處轉(zhuǎn)移,隨訪期間無粘連性腸梗阻發(fā)生。結(jié)論經(jīng)腹膜外途徑行改良逆行膀胱全切術(shù)治療男性肌層浸潤性膀胱癌術(shù)中出血較少,腹腔干擾少,損傷較小,患者術(shù)后恢復(fù)快,住院時間縮短,粘連性腸梗阻發(fā)生率較低,療效較好。
[Abstract]:Objective to observe the effect of modified retrograde cystectomy via extraperitoneal approach in the treatment of male myometrial invasive bladder cancer. Methods retrograde cystectomy was performed on 18 male patients with T 2 stage myometrial invasive bladder cancer. After total cystectomy, bilateral ureterostomy was performed in 4 cases and in situ ileal neobladder was performed in 13 cases. The operative time, intraoperative blood loss, intraoperative blood transfusion and exposure time of abdominal organs were recorded. The time of indwelling, the time of ventilation and the time of hospitalization were recorded. Postoperative complications, local recurrence and distant metastasis. Results all the 18 cases were successfully operated, the operative time was 145 min, the intraoperative bleeding volume was 110 ~ 860 mL, the intraoperative blood transfusion was 3 cases, the intraoperative exposure time of abdominal organs was 0 ~ 65 min, the time of pelvic drainage was 514 days, the postoperative ventilation time was 1 ~ 5 days, the postoperative hospitalization time was 817 days. All the resected tumor tissues were negative for pelvic lymph nodes and received GC regimen chemotherapy. There were no postoperative complications such as hemorrhage, injury of surrounding tissues and organs and infection of incision. All patients were followed up for 3 ~ 28 months. The renal function was normal, no local recurrence or distant metastasis was found, and no adhesive intestinal obstruction occurred during the follow-up. Conclusion modified retrograde total cystectomy via extraperitoneal approach for the treatment of male myometrial invasive bladder cancer has less bleeding, less intraperitoneal interference, less injury, faster postoperative recovery, shorter hospital stay, and lower incidence of adhesive intestinal obstruction. The curative effect is better.
【作者單位】： 安徽省腫瘤醫(yī)院;安徽省立醫(yī)院;
【分類號】：R737.14

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