Radical Cystectomy for Bladder Cancer: Morbidity of Laparoscopic Versus Open Surgery
Radical Cystectomy for Bladder Cancer: Morbidity of Laparoscopic Versus Open Surgery
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DOI：
10.1016/j.juro.2008.10.011
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发表时间：
2009-02-01
影响因子：
6.6
通讯作者：
Rischmann, Pascal
中科院分区：
文献类型：
--
作者：
Guillotreau, Julien;Game, Xavier;Rischmann, Pascal
目的：我们比较了腹腔镜手术与开放手术治疗膀胱癌的发病率和死亡率。材料和方法：这项前瞻性、非随机研究于2003年1月至2007年7月期间对658名接受膀胱癌根治性膀胱切除术的患者（7名女性和61名男性）进行了研究。共38例行腹腔镜膀胱切除术，30例行开放手术。患者平均年龄为68.0 ± 9.0岁。中位术前美国麻醉医师协会评分为2（范围I至3）在这两个group.Results：术中失血量和输血率显着降低腹腔镜手术组。术后轻微并发症的发生率和死亡率也明显降低。腹腔镜手术组的术后阿片类药物消耗量和持续时间显著较少。腹腔镜手术组恢复口腔液体和固体摄入以及恢复正常肠功能明显更快，平均住院时间明显更短。平均患者随访30.5 +/- 17.2 months.Conclusions：腹腔镜根治性膀胱切除术的膀胱癌有较低的发病率比开放手术膀胱切除术。它可以更快地恢复口腔液体和固体摄入，恢复正常的肠道功能，缩短住院时间。
Purpose: We compared the morbidity and mortality of laparoscopic vs open surgery in radical cystectomy for bladder cancer.Materials and Methods: This prospective, nonrandomized study was conducted between January 2003 and July 2007 in 658 patients (7 women and 61 men) who underwent radical cystectomy for bladder cancer. A total of 38 cystectomies were performed laparoscopically and 30 by open surgery. Mean patient age was 68.0 +/- 9.0 years. Median preoperative American Society of Anesthesiologists score was 2 (range I to 3) in both groups.Results: Intraoperative blood loss and transfusion rate were significantly lower in the laparoscopic surgery group. Postoperatively the incidence of minor complications and mortality were also significantly lower. Postoperative opioid consumption was significantly less in the laparoscopic surgery group in amount and duration. Resumption of oral fluid and solid intake as well as return to normal bowel function were significantly more rapid in the laparoscopic surgery group, and mean hospital stay was significantly shorter. Mean patient followup was 30.5 +/- 17.2 months.Conclusions: Laparoscopic radical cystectomy for bladder cancer has a lower morbidity rate than cystectomy by open surgery. It allows more rapid resumption of oral fluid and solid intake as well as return to normal bowel function and shorter hospital stay.