目的探讨在基层医院采用腹腔镜下全膀胱切除原位回肠新膀胱术的临床应用。方法浸润性膀胱癌患者5例,年龄60～65岁,男3例,女2例。采用OLYMPUS腹腔镜根治性切除膀胱后通过腹壁小切口形成回肠新膀胱,然后在腹腔镜下将新膀胱与尿道吻合。结果 5例患者手术均成功。手术平均时间8 h,出血量平均280 ml。术后2周拔除输尿管支架管,术后3周拔除导尿管。术后随访时间5～19个月,除1例女性患者外均能控制排尿,肾功能电解质大致在正常范围,未见肿瘤复发及远处转移。结论腹腔镜下全膀胱切除原位回肠新膀胱术使传统的膀胱癌根治手术实现微创化,术中出血少,术后恢复快,在基层医院开展已成为可能。 Objective To explore the clinical application of laparoscopic total cystectomy in situ ileal neo-bladder surgery in primary hospitals. Methods 5 cases of invasive bladder cancer patients, aged 60 to 65 years, 3 males and 2 females. OLYMPUS laparoscopic radical resection of the bladder through the small incision of the abdominal wall to form a new ileal ileum, laparoscopy and then the new bladder and urethra anastomosis. Results All the 5 patients were successfully operated. The average operation time was 8 h, the average amount of bleeding was 280 ml. Ureteral stent was removed 2 weeks after operation and the catheter was removed 3 weeks after operation. The follow-up time ranged from 5 to 19 months. Except 1 female patient, urinary excretion was controlled. The electrolyte of renal function was in the normal range. No tumor recurrence or distant metastasis was observed. Conclusions Laparoscopic total cystectomy in situ ileal neo-bladder surgery makes traditional radical surgery of bladder cancer minimally invasive, with less intraoperative bleeding and rapid postoperative recovery, which has become possible in primary hospitals.