Clinical Study On Reserving Of Peritoneal Integrity In Radical Cystectomy And Ileal Conduit

Objective To investigate the impact of peritoneal integrity retaining in the surgery ofradical cystectomy and ileal conduit,on the postoperative pain， recovery ofgastrointestinal function and the incidence of intestinal obstruction and othercomplications.Methods From January2007to March2012，according to the breakage of theperitoneal in the opration,67cases were divided into two goups: the peritonealcomplete group（30cases） and peritoneal non-intact group（37cases）. The significantmarkers and therapeutic results were recorded and analyzed, which includes meanoperative time, intraoperative blood loss, postoperative pain, analgesics requirement,use of gastric tube, defecation, recovery of intestinal function, length of stay and theincidence of intestinal obstruction and other complication rate.Results There was no significant difference in the mean operation time（[325.6±78.5）,（308.2±69.3）min], intraoperative blood loss[（458.4±104.2）,（502.0±107.7）ml]between two groups (p>0.05). The peritoneal complete group showed statisticallysignificant better results on postoperative pain[（3.0±1.2）,（3.6±1.0）d], analgesicsrequirement[（2.0±1.3）,（2.7±1.4）d], the use of gastric tube[（4.2±2.7）,（6.3±4.5）d], defecation[（3.2±1.8）,（4.3±1.9）d], recovery of intestinal function[（4.4±2.3）,（5.6±2.2）d], postoperative hospital stay（[29.0±8.5）（,34.6±10.1）d] and the incidenceof intestinal obstruction(3.3%,21.6%) and other complications (p <0.05).Conclusions Radical cystectomy and ileal conduit with keeping the integrity of the peritoneal does not affect the mean operation time, intraoperative blood loss. It has theadvantages of less postoperative pain, shorter recovery of intestinal function, lessincidence of intestinal obstruction and shorter postoperative hospital stay.