尿道途径辅助下经脐单孔腹腔镜根治性全膀胱切除术

发布时间：2018-02-05 05:44

本文关键词： 膀胱癌根治性全膀胱切除术单孔腹腔镜手术　出处：《南京医科大学学报(自然科学版)》2015年02期 　论文类型：期刊论文

【摘要】：目的 :评价经尿道途径辅助下经脐单孔腹腔镜根治性全膀胱切除术的可行性及其优势。方法 :2014年10~12月,2例男性膀胱癌患者采用多通道套管,在经尿道途径辅助下,行经脐单孔腹腔镜根治性全膀胱切除、双侧盆腔淋巴结清扫及单乳头双输尿管一侧腹壁造口术。操作全部在单孔腹腔镜下进行。收集围手术期及术后资料进行分析。结果:2例手术均顺利完成,无中转常规腹腔镜或开放手术。单孔平均手术时间为4.15 h。术中平均出血量为150 ml,平均术后住院时间为15 d。围手术期内无严重并发症发生。术后病理示2例手术标本切缘均为阴性,平均清扫淋巴结16.5个,前者3/15阳性,后者0/18阳性。结论:经尿道辅助的经脐单孔腹腔镜行全膀胱根治性切除术安全可行。该术式减少了腹腔镜与操作器械之间的相互干扰,降低了手术难度和风险,手术并发症发生率低。
[Abstract]:Objective: to evaluate the feasibility and advantages of transurethral assisted laparoscopic radical cystectomy through umbilical single orifice. Methods: from 2014 to December. Two male patients with bladder cancer were treated with transurethral laparoscopic radical cystectomy with transurethral approach. Bilateral pelvic lymph node dissection and unilateral abdominal wall ostomy of single papilla and double ureter were performed under single-hole laparoscopy. The perioperative and postoperative data were collected and analyzed. There was no conversion to conventional laparoscopy or open surgery. The average operation time was 4.15 hours and the average blood loss was 150ml. The average postoperative hospitalization time was 15 days. There were no serious complications during the perioperative period. Postoperative pathology showed that the incision margin of 2 cases was negative and the average number of dissected lymph nodes was 16. 5. The former was 3/15 positive. The latter was 0/18 positive. Conclusion: transurethral assisted laparoscopic total cystectomy is safe and feasible. It reduces the interference between laparoscopy and operating instruments. The difficulty and risk of operation were reduced, and the incidence of complications was low.
【作者单位】：南京中医药大学附属江苏省中医院泌尿外科;
【基金】：国家自然科学基金(81273547)
【分类号】：R737.14
【正文快照】： 根治性全膀胱切除术是治疗浸润性膀胱癌和反复发作的非肌层浸润性膀胱癌的首选手术方法。之前已有腹腔镜全膀胱切除术的经验报道[1-3],但是国内外鲜有单位报道单孔腹腔镜(LESS)全膀胱切除术,其原因主要是由于腹腔镜与操作器械之间的碰撞干扰,使得手术难度和风险增加,从而制约

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