CAJ | 학술논문

目的探讨腹腔镜全膀胱切除-新膀胱术的手术方法和临床效果.方法膀胱移行细胞癌患者5例, 27～64岁(平均49.8岁).均经腹腔镜下行全膀胱切除- 原位回肠膀胱术,经腹壁切口取出标本,然后将回肠牵出切口截取40 cm长回肠段,剖开建成"M"型贮尿囊,并与双侧输尿管吻合再置入腹腔与腹腔镜下行贮尿囊尿道吻合建成原位回肠膀胱.行回肠新膀胱术. 结果 5例手术均获成功,手术时间5～7 h,平均6.0 h.出血量200～510 ml,平均340 ml,无输血.术后2～3天恢复肠道功能.术后三个月随访时患者排尿良好,新膀胱无明显残余尿,容量200～350 ml.结论腹腔镜全膀胱切除-原位回肠膀胱术创伤小、出血少、恢复快,很有前景,但还需要长时间随机对照和随访研究.
목적 탐토복강경전방광절제-신방광술적수술방법화림상효과.방법 방광이행세포암환자5례, 27～64세(평균49.8세).균경복강경하행전방광절제- 원위회장방광술,경복벽절구취출표본,연후장회장견출절구절취40 cm장회장단,부개건성"M"형저뇨낭,병여쌍측수뇨관문합재치입복강여복강경하행저뇨낭뇨도문합건성원위회장방광.행회장신방광술. 결과 5례수술균획성공,수술시간5～7 h,평균6.0 h.출혈량200～510 ml,평균340 ml,무수혈.술후2～3천회복장도공능.술후삼개월수방시환자배뇨량호,신방광무명현잔여뇨,용량200～350 ml.결론 복강경전방광절제-원위회장방광술창상소、출혈소、회복쾌,흔유전경,단환수요장시간수궤대조화수방연구.
Objective To study the surgical procedure and results of laparoscopic radical cystectomy (LRC) with orthotopic neobladder. Methods 5 patients with bladder transitional cell carcinoma underwent LRC, the age ranged from 27 to 64 years old (mean 49.8 years old). The ileal pouch (so called neobladder) were made from out of the median incision in the lower abdomen. Results All the operation were finished successfully, the duration of surgery ranged from 5 to 7 hours, mean 6.1 hours. The blood loss was 200 to 510 ml, no one needed blood transfusion. The intestine function recovered about 2～3 days after operation. After 3 months follow-up after surgery, all patients avoided well, no residual urine in the neobladders by ultrasonography, the neobladder volume was 200～350 ml. Conclusion With minimal invasion, less blood loss and rapid recovery , LRC with othotopic ileal neobladder is a promising way for the patients who have the indication,but need a long-term random control and catamnestic research.