中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
7期
749-753
,共5页
机器人辅助%腹腔镜%尿流改道术%膀胱癌
機器人輔助%腹腔鏡%尿流改道術%膀胱癌
궤기인보조%복강경%뇨류개도술%방광암
Robotic-assisted%Laparoscopy%Urinary diversion%Bladder cancer
目的 探讨机器人辅助腹腔镜下膀胱全切-尿流改道术(RARC)在治疗膀胱癌安全性与有效性.方法 收集北京二炮总医院于2010年3月运用Da Vi nci机器人辅助腹腔镜行根治性膀胱切除-回肠膀胱术治疗1例膀胱癌资料.通过仔细阅读近期国内外相关文献,并进行分析.结果 (1)该病例手术时间为540 min,术中失血量为200 ml,输血0ml,术后第3天排气,术后第4天下床活动,术后病理检查提示:低级别浸润型尿路上皮癌,术后第28天出院.(2)国内外RARC已超过400例.RARC组并发症发生率(31％与28％)、淋巴结清扫数(18.2个与13.0个)略高于常规腹腔镜下膀胱切除-尿流改道术(LCR)组；RARC组手术时间(285.7 min与372.0 min)、术中失血量(286.4 ml与556.0 ml)、平均住院日(8.6d与13 d)低于LCR组.结论 RARC为有效的治疗膀胱癌的新术式,因国内外样本量较少,手术经验不足.需以后进行大样本、长期随访的高质量临床研究,并及时更新系统评价其有效性和安全性.
目的 探討機器人輔助腹腔鏡下膀胱全切-尿流改道術(RARC)在治療膀胱癌安全性與有效性.方法 收集北京二砲總醫院于2010年3月運用Da Vi nci機器人輔助腹腔鏡行根治性膀胱切除-迴腸膀胱術治療1例膀胱癌資料.通過仔細閱讀近期國內外相關文獻,併進行分析.結果 (1)該病例手術時間為540 min,術中失血量為200 ml,輸血0ml,術後第3天排氣,術後第4天下床活動,術後病理檢查提示:低級彆浸潤型尿路上皮癌,術後第28天齣院.(2)國內外RARC已超過400例.RARC組併髮癥髮生率(31％與28％)、淋巴結清掃數(18.2箇與13.0箇)略高于常規腹腔鏡下膀胱切除-尿流改道術(LCR)組；RARC組手術時間(285.7 min與372.0 min)、術中失血量(286.4 ml與556.0 ml)、平均住院日(8.6d與13 d)低于LCR組.結論 RARC為有效的治療膀胱癌的新術式,因國內外樣本量較少,手術經驗不足.需以後進行大樣本、長期隨訪的高質量臨床研究,併及時更新繫統評價其有效性和安全性.
목적 탐토궤기인보조복강경하방광전절-뇨류개도술(RARC)재치료방광암안전성여유효성.방법 수집북경이포총의원우2010년3월운용Da Vi nci궤기인보조복강경행근치성방광절제-회장방광술치료1례방광암자료.통과자세열독근기국내외상관문헌,병진행분석.결과 (1)해병례수술시간위540 min,술중실혈량위200 ml,수혈0ml,술후제3천배기,술후제4천하상활동,술후병리검사제시:저급별침윤형뇨로상피암,술후제28천출원.(2)국내외RARC이초과400례.RARC조병발증발생솔(31％여28％)、림파결청소수(18.2개여13.0개)략고우상규복강경하방광절제-뇨류개도술(LCR)조；RARC조수술시간(285.7 min여372.0 min)、술중실혈량(286.4 ml여556.0 ml)、평균주원일(8.6d여13 d)저우LCR조.결론 RARC위유효적치료방광암적신술식,인국내외양본량교소,수술경험불족.수이후진행대양본、장기수방적고질량림상연구,병급시경신계통평개기유효성화안전성.
Objective To assess the safety and effectiveness of robotic-assisted laparoscopic radical cystcctomy and urinary diversion in the treatment of bladder cancer.Methods We collected the clinical data of one patient with bladder cancer who underwent RCRA with ileal neobladder from the Second Artillery General Hospital in Beijing on March,2010.Literature on this topic was analyzed.Results ( 1 ) Tbc operation duration of this procedure was 540 mins.The intra-operative blood loss was 200 ml,and no blood transfusion was needed.Postoperative pathologic examination indicated low-grade infiltrative urothelial carcinoma.The patient exhausted on the 3th post-operative day,had off-bed activities on the 4th post-operative day,and was discharged on the 28th post-operative day.(2) There were more than 400 patients underwent RARC worldwide.The RARC group had marginally lower complications rate (31％ vs.28％ ) and numbers of lymph node dissection ( 18.2 vs.13.0) than the LCR group.There were significant differences in the duration of operation (285.7 mins vs.372.0 mins),intraoperatie blood loss ( 286 ml vs.556.0 ml) and mean days of hospitalization ( 8.6 d vs.13.0 d) between the RARCA and the LCR groups.Conclusion RARC is a novel and effective procedure for the treatment of bladder cancer.As there is only a relatively small sample around the world and little experience on this procedure can be referred,more clinical practice with RARC and high quality research with long-term follow-up are needed to update the database and evaluate its effectiveness and safety.
