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目的:观察腹腔镜下保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术治疗肌层浸润性膀胱癌的临床疗效。方法:我院于2011年6月~2015年3月期间对21例选择性的男性患者施行了腹腔镜下保留部分前列腺包膜的膀胱全切术-原位回肠膀胱术,记录患者围手术期并发症,并对患者术后肾功能、尿控功能、性功能、肿瘤控制效果等进行随访。结果:所有患者均顺利完成手术。无严重的围手术期并发症及术后短期长期并发症。随访时间8~39个月,平均26个月。术后1年(除随访8个月1例外),白天尿控率为95%(19/20),夜尿次数0~5次,平均3.5次,夜间尿控率为80%(16/20);恢复勃起功能患者比例为80%(16/20)。末次随访时患者未见局部肿瘤复发或者转移。结论:腹腔镜下保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术对于选择性的肌层浸润性膀胱癌患者具有良好的治疗效果。
OBJECTIVE: To observe the curative effect of laparoscopic radical cystectomy for the preservation of the prostatic capsule - the clinical efficacy of ileal neo-bladder surgery in the treatment of invasive bladder cancer. Methods: From June 2011 to March 2015, 21 cases of selective male patients underwent laparoscopic partial cystectomy for bladder resection - ileal ileal bladder surgery, recording the perioperative period of patients Complications, and postoperative renal function, urinary control function, sexual function, tumor control effect were followed up. Results: All patients successfully completed the operation. No serious perioperative complications and postoperative short-term long-term complications. Follow-up time of 8 to 39 months, an average of 26 months. One year after operation (except one case of follow-up of 8 months), the rate of urinary control during the day was 95% (19/20), the number of nocturnal urination was 0 ~ 5 times (average 3.5 times) and nighttime urine control rate was 80% (16/20 ); The percentage of patients with erectile dysfunction was 80% (16/20). The last follow-up of patients with no local tumor recurrence or metastasis. CONCLUSIONS: Laparoscopic radical cystectomy with retained prostatic capsular-ileal neo-bladder surgery has a good therapeutic effect on patients with selective muscle-invasive bladder cancer.