两种不同手术方式对女性膀胱癌患者远期预后的影响比较

刘志飞; 邢力永; 朱研峰; 石鹏; 邓刚

doi:10.13201/j.issn.1001-1420.2021.04.013

两种不同手术方式对女性膀胱癌患者远期预后的影响比较

- 唐山市人民医院泌尿外科(河北唐山, 063000)
基金项目:
河北省卫计委医学研究课题计划(No:20171274)

详细信息

通讯作者: 刘志飞,E-mail:liuzhifei1107@163.com

中图分类号: R737.14

收稿日期: 2020-07-24

Comparison of the effects between two different surgical methods on long-term prognosis of female bladder cancer patients

- Department of Urology, Tangshan People's Hospital, Tangshan, Hebei, 063000, China

More Information

Corresponding author: LIU Zhifei, E-mail: liuzhifei1107@163.com

Received Date: 24 July 2020

摘要

摘要: 目的:比较两种不同手术方式对女性膀胱癌患者围手术期情况和远期预后的影响。方法:采用回顾性研究,收集本院93例行根治性膀胱全切术的女性膀胱癌患者临床资料,其中开放膀胱全切术39例(开放组)、腹腔镜膀胱全切术54例(腹腔镜组)。分别采用单因素分析和Cox回归分析影响患者预后的相关因素。结果:两组入院时体重指数(BMI)、肿瘤T分期和N分期、病理级别、手术时间、术后住院天数、新辅助/辅助化疗情况的比较,差异均无统计学意义(P＞0.05)。腹腔镜组平均年龄、术前美国麻醉医师协会(ASA)分级、术中输血率、皮肤输尿管造口术的比例及围手术期并发症发生率均低于开放组,原位新膀胱术的比例高于开放组,术中出血量少于开放组,淋巴结清扫数量多于开放组(P＜0.05)。开放组和腹腔镜组中位随访时间分别为27个月和25个月。两组总生存期的比较,差异无统计学意义(P＞0.05)。经Cox回归分析发现,年龄、术前ASA分级、术中出血量、术中输血率、淋巴结清扫数量、围手术期是否发生并发症均并非预测女性膀胱癌患者预后状况的独立因子(P＞0.05)。结论:相比开放膀胱全切术,腹腔镜膀胱全切术中出血量较少、术中输血率较低、淋巴结清扫数量较多、围手术期并发症发生率较低,但本研究未发现腹腔镜膀胱全切术可明显延长女性膀胱癌患者生存期,未发现其预后明显优于开放膀胱全切术。
- 膀胱癌 /
- 膀胱全切术 /
- 腹腔镜 /
- 总生存期 /
- 女性
Abstract: Objective: To compare the effects between two different surgical methods on perioperative and long-term prognosis of female bladder cancer patients.Methods: A retrospective study was conducted to collect the clinical data of 93 female patients with bladder cancer who underwent radical cystectomy in our hospital. Univariate analysis and Cox logistic regression were used to analyze the influencing factors of prognosis.Results: There was no significant difference in body mass index(BMI), tumor T stage or N stage, pathological grade, operation time, postoperative hospital stay or neoadjuvant/adjuvant chemotherapy between the two groups(P＞0.05). The average age, preoperative American Society of Anesthesiologists(ASA) classification, intraoperative blood transfusion rate, the proportion of skin ureterostomy and the incidence of perioperative complications in laparoscopic group were lower than those in open group. The proportion of in situ neobladder surgery was higher than that of open group, and intraoperative blood loss was less than that of open group. The number of lymph node dissection was more than that of open group(P＜0.05). The median follow-up time of open group and laparoscopic group were 27 and 25 months respectively. There was no significant difference in overall survival between the two groups(P＞0.05). Cox logistic regression analysis showed that age, preoperative ASA grade, intraoperative blood loss, intraoperative blood transfusion rate, number of lymph node dissection and perioperative complications were not independent factors to predict the prognosis of female bladder cancer patients(P＞0.05).Conclusion: Compared with open total cystectomy, laparoscopic total cystectomy has less blood loss, lower blood transfusion rate, more lymph node dissection and lower incidence of perioperative complications. However, this study did not find that laparoscopic total cystectomy can significantly prolong the survival time of female bladder cancer patients, and its prognosis is not significantly better than open cystectomy.
- bladder cancer /
- total cystectomy /
- laparoscopy /
- overall survival /
- female

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