腹腔镜膀胱癌根治术回肠原位新膀胱术远期治疗效果研究-study on long-term therapeutic effect of laparoscopic radical cystectomy with ileum orthotopic neobladder.docxVIP

ABSTRACTObjective：Assessment the long-term clinical results of laparoscopic radical resection of bladder cancer + orthotopic ileal neobladder for bladder cancer .Methods：Collected a total of 87 males and 7 females from March 2008 to October 2014, who had have laparoscopic radical resection of bladder cancer + orthotopic ileal neobladder at the First Affiliated Hospital of Nanchang University. Collected data of cases demographics, preoperative complications, pathological staging, postoperative chemotherapy, more than 3 months postoperative survival and recurrence in patients with follow-up status, the results were statistically analyzed.Result:In this study, all of the 94 patients underwent laparoscopic radical resection of bladder cancer + orthotopic ileal neobladder. 83 cases of which had standard pelvic lymphadenectomy, the average number of removed lymph nodes was 14.23 ± 7.86.Other 11 cases had extensive pelvic lymphadenectomy, the average number of removed lymph nodes was 19.4 ± 10.26. The pathological staging after surgical: 24 (25.5%) cases had Lymph node metastasis, 40 （ 42.5% ） cases’ tumers were non-organ confined. The median follow-up time is 26 monthes (3 ～ 54 monthes). There were 4 cases had lost, 37 cases（39.3%）had finished more than 30 monthes follow-up, 67 cases （ 71.3% ） had no postoperative metastasis and recurrence, 23 cases （24.5%）had tumer progression (1 case had neobladder recurrence, 9 cases hadlocal recurrence, 13 case had distant metastasis). 27 patients had died (17 out of which died of tumor progression, 10 out of which died of other reasons). The rates ofoverall survival(OS) and relapse-free survival （ RFS) after 36 monthes ofpostoperative were 70 ％ 、 77 ％ respectively. Postoperative urinary continence (follow-up more than 90 days ): there was no patient had complete urinary incontinence which need catheterization or pseudo catheterization at daytime. 8patients controled slightly worse(3 persons need more than 2 pieces