CAJ | 학술논문

目的比较回肠膀胱术与原位回肠新膀胱术的近期临床疗效.方法回顾性分析行根治性膀胱全切除术加尿流改道的62例膀胱癌患者的临床资料,其中32例行原位回肠新膀胱术(原位回肠新膀胱术组),30例行回肠膀胱术(回肠膀胱术组),比较两组患者的手术时间、术中失血量、肠功能恢复时间、住院时间及术后早期(术后3个月内)并发症.结果两组62例患者均手术成功,无手术死亡发生.原位回肠新膀胱术组和回肠膀胱术组术后肠功能恢复时间比较差异无统计学意义(P＞0.05).原位回肠新膀胱术组手术时间、术中失血量、住院时间均明显高于回肠膀胱术组[(463.59±50.24)min比(436.07±44.91)min、(1081.16±320.49)ml比(867.53±224.61)ml、(46.88±4.67)d比(20.37±5.24)d],但原位回肠新膀胱术组术后早期并发症发生率明显少于回肠膀胱术组[25.0％(8/32)比53.3％(16/30)],差异均有统计学意义(P＜0.05).结论两种尿流改道术均是临床上尿流改道的较成熟方式,在临床诊疗中临床医生应根据患者的综合情况,并结合临床经验选择最合适的术式.
목적 비교회장방광술여원위회장신방광술적근기림상료효.방법 회고성분석행근치성방광전절제술가뇨류개도적62례방광암환자적림상자료,기중32례행원위회장신방광술(원위회장신방광술조),30례행회장방광술(회장방광술조),비교량조환자적수술시간、술중실혈량、장공능회복시간、주원시간급술후조기(술후3개월내)병발증.결과 량조62례환자균수술성공,무수술사망발생.원위회장신방광술조화회장방광술조술후장공능회복시간비교차이무통계학의의(P＞0.05).원위회장신방광술조수술시간、술중실혈량、주원시간균명현고우회장방광술조[(463.59±50.24)min비(436.07±44.91)min、(1081.16±320.49)ml비(867.53±224.61)ml、(46.88±4.67)d비(20.37±5.24)d],단원위회장신방광술조술후조기병발증발생솔명현소우회장방광술조[25.0％(8/32)비53.3％(16/30)],차이균유통계학의의(P＜0.05).결론 량충뇨류개도술균시림상상뇨류개도적교성숙방식,재림상진료중림상의생응근거환자적종합정황,병결합림상경험선택최합괄적술식.
Objective To compare the recent clinical efficacy between ileal neobladder and orthotopic ileal neobladder.Methods The clinical data of 62 patients with bladder cancer who were performed with cystectomy plus urinary diversion were retrospectively analyzed.Among them,32 patients were performed with orthotopic ileal neobladder(orthotopic ileal neobladder group)and 30 patients were performed with ileal neobladder(ileal neobladder group).The operation time,intraoperative bleeding,intestinal function recovery time,hospital stay,early postoperative complications were compared between two groups.Results All the patients were successful,and there was no operative deaths occurred.There was no significant difference in the postoperative intestinal function recovery time between two groups(P ＞ 0.05).The operation time,intraoperative bleeding,hospital stay in orthotopic ileal neobladder group was higher than that in ileal neobladder group [(463.59 ± 50.24)min vs.(436.07 ± 44.91)min,(1081.16 ± 320.49)ml vs.(867.53 ± 224.61)ml,(46.88 ± 4.67)d vs.(20.37 ± 5.24)d],but the incidence of early postoperative complications in orthotopic ileal neobladder group was lower than that in ileal neobladder group [25.0％(8/32)vs.53.3％(16/30)],and there were significant differences between two groups(P ＜0.05).Conclusions Two kinds of urinary diversion surgical urinary diversion are clinically more mature manner,in clinical practice.Clinicians should be based on the patient's comprehensive situation,combined with the clinical experience to select the most appropriate surgical procedures.