Laparoscopic partial prostatic capsule sparing cystectomy with orthotopic ileal neobladder:a serial of clinical outcomes
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摘要: 目的:观察腹腔镜下保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术治疗肌层浸润性膀胱癌的临床疗效。方法:我院于2011年6月~2015年3月期间对21例选择性的男性患者施行了腹腔镜下保留部分前列腺包膜的膀胱全切术-原位回肠膀胱术,记录患者围手术期并发症,并对患者术后肾功能、尿控功能、性功能、肿瘤控制效果等进行随访。结果:所有患者均顺利完成手术。无严重的围手术期并发症及术后短期长期并发症。随访时间8~39个月,平均26个月。术后1年(除随访8个月1例外),白天尿控率为95%(19/20),夜尿次数0~5次,平均3.5次,夜间尿控率为80%(16/20);恢复勃起功能患者比例为80%(16/20)。末次随访时患者未见局部肿瘤复发或者转移。结论:腹腔镜下保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术对于选择性的肌层浸润性膀胱癌患者具有良好的治疗效果。
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关键词:
- 腹腔镜保留部分前列腺包膜膀胱全切术 /
- 原位回肠新膀胱术 /
- 肌层浸润性膀胱癌 /
- 勃起功能 /
- 尿控功能
Abstract: Objective:To investigate the oncological and functional outcomes of laparoscopic partial prostatic capsule sparing cystectomy with orthotopic ileal neobladder for selected patients with muscle invasive bladder cancer.Method:From June 2011 to March 2015,21 selected cases underwent laparoscopic partial prostatic capsule sparing cystectomy with orthotopic ileal neobladder.Their operative time,blood loss,periopertaive complications,postoperative outcomes,sexual function,continence and oncological control were recorded.Result:The operation was completed successfully in all patients.There was no severe perioperative complications.The follow-up duration was 8-39(mean,26)months.One year after the operation(follow-up period of eight months for one case),the daytime continence rate was 19/20(95%),the nighttime continence rate was 16/20(80%),erectile function was maintained in 16/20(80%)cases.There was no local recurrence or metastasis at the last follow-up.Conclusion:Laparoscopic partial prostatic capsule sparing cystectomy with orthotopic ileal neobladder can be used in selected patients with muscle invasive bladder cancer with good efficacy and tumor control. -
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