| Objective:Comparison of laparoscopic radical cystectomy, go with the sigmoid colon orthotopic neobladder (LRC-NB) surgery and open surgery (ORC-NB) complex surgical approach and treatment.Methods:Divided thirty-seven bladder cancer patients to LRC-NB(Group A,17patients,16men,1 female) and ORC-NB(GroupB,20patients,18men and 2 female)from January 2005 to December 2010 at Urologic Surgery department of 208 hospital of PLA.Compared and analysis two groups with operation methods, surgical time, blood loss, therapeutic effect, complications and hospital stay, the change of micturation, the recovered of sexual function of men patients and the control of tumor.Results:The LRC-NB(Group A) is more complicated than ORC-NB(Group B), groups. The mean operative time was 504.12 min in Group A vs 361.65 min in Group B (P<0.05), The mean intraoperative blood loss was618.88mL in Group A vs 1599.00mL in Group B (P<0.05), The mean oral intake after operation was 3.69days in the LRC group and 10.10days in ORC group (p<0.05).The hospitalize time after operation was 19.24day in the LRC group and 27.45 days in ORC group (p<0.05) The rate of complications is 35.29% in Group A vs 45.00% in Group B(P<0.05).The continence of micturition is 76.47%in Group A in day-time and 70.58% in night-time vs 70.00% in day-time,65.00% in night-time of Group B after 3 months of operation, the continence of micturition is 88.24% in the day-time,82.35% in the night-time of Group A vs 80.00% in the day-time,80.00% in the night-time of Group B after 6 months of operation (P>0.05).The volume of nebladder is 418.47mL in Group A vs 419.29mL in Group B (P>0.05) after 3 months of operation and 460.71mL in Group A vs 458.65mL (P>0.05) in Group B after 6 months.No patient was hydronephrosis in Group A, lcase of both side hydronephrosis in Group B after 3 months of operation and 3 case (include 1 above) after 6 months of operation. There are 2(11.76%) male patients' penis could erection in Group A after 6 months of operation vs 2cases(2.98%) in Group B.One patient has pelvic lymphatic metastasis in Group A after 3 months of operation, Group B have no case of tumor recurrence.Conclusions:LRC-NB is more complex than ORC-NB, has more requirements on equipment,need more operation time, but less blood loss, shorter oral intake time, and have less hospital stay, less short term postoperative complications.That was no significant difference of the change of micturation and the postoperative complications and recovered of sexual function of men patients have no significant difference.There is not exact conclusions of the control of tumor between two operations. |
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