基于层面外科的程序化五步法腹腔镜根治性膀胱切除术在老年男性中的应用OA
Application of programmatic five-step laparoscopic radical cystectomy based on trans-interfascial plane surgery in elderly male patients
目的 探讨基于层面外科解剖技术的程序化五步法腹腔镜根治性膀胱切除术(LRC)在老年男性患者中的临床应用效果.方法 回顾性分析我院泌尿外科收治的103例老年男性膀胱癌患者的临床资料,按手术方式分为改良组(n=59,行基于层面外科的程序化五步法LRC)与传统组(n=44,行传统LRC).比较2组患者的围术期指标、术后并发症情况及随访期间患者肿瘤复发与死亡情况.结果 改良组患者手术时间、术后首次进食时间、术后留置引流管时间、术后住院时间均短于传统组(P<0.05),术中出血量少于传统组(P<0.05),术后3 d血红蛋白下降值低于传统组(P<0.05),而淋巴结清扫数量与传统组比较,差异无统计学意义(P>0.05);改良组术后并发症总发生率(13.6%)低于传统组(31.8%),差异有统计学意义(P<0.05);2组患者随访期复发率、病死率比较,差异无统计学意义(P>0.05).结论 基于层面外科的程序化五步法LRC具有解剖层面清晰、手术损伤小、康复快等优势,是老年男性患者安全、高效的手术选择.
Objective To investigate the clinical efficacy of programmatic five-step laparoscopic radical cystectomy(LRC)based on trans-interfascial plane surgical anatomy in elderly male patients.Methods A retrospective analysis was conducted on the clinical data of 103 elderly male patients with bladder cancer admitted to the Department of Urology in our hospital.The patients were divided into the modified group(n=59,treated with programmatic five-step LRC based on trans-interfascial plane surgery)and the traditional group(n=44,treated with conventional LRC)according to the surgical methods.Perioperative indicators,postoperative complications,as well as tumor recurrence and mortality during the follow-up were compared between the two groups.Results The operation time,time to first oral intake,duration of drainage tube placement,and postoperative hospital stay of patients in the modified group were shorter than those in the traditional group(P<0.05);the intraoperative blood loss of patients in the modified group was less than that in the traditional group(P<0.05);the decrease value of hemoglobin of patients in the modified group 3 days after operation was lower than that in the traditional group(P<0.05).However,there was no significant difference in the number of dissected lymph nodes between the two groups(P>0.05).The total incidence of postoperative complications in the modified group(13.6%)was lower than that in the traditional group(31.8%),and the difference was statistically significant(P<0.05).There was no significant difference in the recurrence rate or mortality rate between the two groups during the follow-up(P>0.05).Conclusion The programmatic five-step LRC based on trans-interfascial plane surgery has the advantages such as clear anatomical planes,minimal surgical trauma,and rapid recovery,and it is a safe and effective surgical option for elderly male patients.
李佳;吕东晨;李鑫华;臧天铭;党越;郭博洋;李三祥
内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017包头医学院研究生院,内蒙古 包头 014040内蒙古自治区人民医院泌尿外科,内蒙古 呼和浩特 010017
医药卫生
层面外科程序化根治性膀胱切除术肌层浸润性膀胱癌腹腔镜老年男性
trans-interfascial plane surgeryprogrammaticradical cystectomymuscle invasive bladder cancerlaparoscopicelderly male
《局解手术学杂志》 2026 (4)
333-337,5
内蒙古自治区"十四五"社会公益领域重点研发和成果转化计划项目(2023YFSH0031)
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