田建海,周鲁莲,郭怀远,徐建平,任统,李传波,林瑞
TIAN Jianhai,ZHOU Lulian,GUO Huaiyuan,XU Jianping,REN Tong,LI Chuanbo,LIN Rui

• 1:临沂市肿瘤医院泌尿外科
• 2:临沂市肿瘤医院胸外二科

摘要(Abstract)：

目的 比较腹腔镜下膀胱根治切除术前或术后盆腔淋巴结清扫对患者疗效的影响。方法 102例膀胱癌患者均分为术后清除组（于膀胱癌根治术后行盆腔淋巴结清扫术）与术前清除组（于膀胱癌根治术前行盆腔淋巴结清扫术），比较两组患者盆腔淋巴结清扫时间、膀胱全切时间、出血量，观察髂内、髂外、髂前、闭孔、骶前、腹膜外各部位的淋巴结清扫数目及总数；比较两组患者术前、术后第1天、出院前1 d的红细胞比容（HCT）、白蛋白（ALB）、肌酐（Scr）及无病生存率（DFS）、生存时间。结果 两组患者盆腔淋巴结清扫时间、出血量、并发症总发生率比较，差异无统计学意义（P> 0.05）；术后清除组的膀胱全切时间、无病生存时间长于术前清除组，而盆腔淋巴结清扫总数、DFS高于术前清除组，差异有统计学意义（P<0.05）；两组患者HCT、ALB、Scr与同时点术前清除组比较，差异无统计学意义（P> 0.05）。结论 腹腔镜下膀胱癌根治术后行盆腔淋巴结清扫术淋巴结清扫数量多、患者DFS高，临床疗效优于膀胱癌切除术前行盆腔淋巴结清扫术。
Objective To compare the treatment effect of laparoscopic pelvic lymph node dissection before or after radical cystectomy.Methods One hundred and two patients with bladder cancer were divided into the observation group( pelvic lymph node dissection was performed after a radical resection of bladder cancer) and the control group(pelvic lymph node dissection was performed before the radical resection of bladder cancer). The pelvic lymph node dissection, total bladder resection and bleeding were compared, and the total number of lymph node dissection in internal iliac, external iliac, anterior iliac, obturum, anterior sacral and extraperitoneal areas were observed. RBC(HCT),albumin(ALB), creatinine( Scr), disease-free survival( DFS), and survival time were compared before surgery, postoperative day 1 and 1 day before discharge in two groups.Results The dissection time of pelvic lymph node, bleeding volume, and total incidence of complications were compared in the two groups, and there was no significant difference(P> 0. 05). The total bladder resection time and disease-free survival time were longer than those in the postoperative dissection group, while the total number of pelvic lymph node dissection and DFS were higher than those in the preoperative dissection group, and the difference was statistically significant(P< 0. 05). There was no significant difference in HCT, ALB, and Scr between the observation group and the control group(P> 0. 05).Conclusion Pelvic lymph node dissection after laparoscopic radical bladder cancer has a large number of patients and high DFS, with better clinical efficacy than pelvic lymph node dissection before bladder cancer resection.

关键词(KeyWords)： 腹腔镜;膀胱癌根治术;盆腔淋巴结清扫术;时机;红细胞比容;白蛋白;肌酐
laparoscopy;radical bladder cancer;pelvic lymph node dissection;timing;hematocrit(HCT);albumin(ALB);serum creatinine(Scr)

Abstract:

Keywords:

基金项目(Foundation): 山东省科技发展计划项目（2019GSF118049）;; 临沂市科技发展计划项目（201919103）

作者(Author): 田建海,周鲁莲,郭怀远,徐建平,任统,李传波,林瑞
TIAN Jianhai,ZHOU Lulian,GUO Huaiyuan,XU Jianping,REN Tong,LI Chuanbo,LIN Rui

DOI: 10.19367/j.cnki.2096-8388.2022.04.015

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