Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis.
Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis.
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DOI：
10.7314/apjcp.2015.16.15.6353
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发表时间：
2015-10
期刊：
影响因子：
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通讯作者：
T. Yasui;K. Tozawa;R. Ando;T. Hamakawa;Shoichiro Iwatsuki;K. Taguchi;D. Kobayashi;T. Naiki;K. Mizuno;A. Okada;Y. Umemoto;N. Kawai;S. Sasaki;Y. Hayashi;K. Kohri
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文献类型：
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作者：
T. Yasui;K. Tozawa;R. Ando;T. Hamakawa;Shoichiro Iwatsuki;K. Taguchi;D. Kobayashi;T. Naiki;K. Mizuno;A. Okada;Y. Umemoto;N. Kawai;S. Sasaki;Y. Hayashi;K. Kohri
背景：探讨三孔腹腔镜根治性膀胱切除术（LRC）与开放根治性膀胱切除术（ORC）在75岁以上患者中的安全性、有效性和肿瘤学结局。材料和方法：从2010年6月至2014年7月，我们分析了16例年龄超过75岁的根治性膀胱切除术患者（LRC组=8例; ORC组=8例）。回顾性收集、分析和比较两组的人口统计学参数、手术变量和围手术期结局。结果两组患者的术前特征相似。与ORC组相比，LRC组的手术时间显著更长（476 vs. 303 min，P=0.0002），估计失血量更少（627 vs. 2，106 mL，P=0.021）。感染和肠梗阻是术后最常见的早期并发症。行ORC的患者发生术后感染（22.2% vs. 0.0%，P=0.054）和肠梗阻（25.0% vs. 12.5%，P=0.521）的比例高于LRC组，但差异无统计学意义。结论从初步试验来看，老年患者可以安全地进行3端口LRC。我们建议3端口LRC作为主要的干预措施，以治疗肌肉浸润性或高风险的非肌肉浸润性膀胱癌的老年患者，否则相对较长的预期寿命。
BACKGROUND To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. MATERIALS AND METHODS From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. RESULTS Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. CONCLUSIONS Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.