微创医学

目的观察保留膀胱手术结合综合疗法治疗浸润性膀胱癌的可行性及近期效果。方法将行保留膀胱手术联合综合治疗的53例浸润性膀胱癌患者为观察组，并将同期行根治性膀胱切除术的50例浸润性膀胱癌患者为对照组，随访6～36个月，比较两组患者近期疗效、复发、副反应、生存质量。结果观察组患者术后平均尿量（279.4±35.7）mL，79.25%的患者膀胱功能正常，90.91%的男性患者性功能恢复；12个月、24个月和36个月生存率分别为94.34%、88.68%和66.04%，3年复发率和转移率分别为22.64%、15.09%，生存率与对照组比较，差异无统计学意义（P＞0.05）。两组化疗副反应发生率分别为24.53%（13/53）、24.00%（12/50），两组比较，差异无统计学意义（P＞0.05）。观察组存活患者术后12个月心理、生理、独立性、社会关系、环境、精神支柱6个领域评分均高于对照组（P＜0.05）。结论保留膀胱手术结合综合疗法近期疗效与根治性膀胱切除术基本相同，但患者生存质量明显提高，是切实可行的手术方法。

ObjectiveTo observe the feasibility and short-term outcome of bladder preserving operation combined with comprehensive treatment for invasive bladder cancer. Methods53 patients with invasive bladder cancer were underwent bladder preserving operation combined with comprehensive treatment, and compared with 50 cases undergoing radical cystectomy. Follow-up for 6-36 months,the short-term effect, recurrence, side effects, quality of life were compared between the two groups. ResultsThe postoperative mean urine volume of the observation group was (279.4±35.7) mL, 79.25% patients preserved normal bladder function, 90.91% male restored sexual function; and the 12-month, 24-month, 36-month survival rates were 94.34%, 88.68%, 66.04%, respectively. Three-year recurrence rate and metastasis rate were 22.64%, 15.09%. There was no significant difference in survival (P＞0.05). The incidence of chemotherapy side reaction was 24.53% (13/53), 24% (12/50), respectively, and there was no significant difference (P＞0.05). In the observation group, psychology, physiology, independence, social relationship, environment, mental pillar 6 domain scores 6 months after operation were higher than those in the control group (P＜0.05). ConclusionBladder preserving operation combined with comprehensive treatment for invasive bladder cancer has the same efficacy as radical cystectomy, while it can significantly improve the quality of life of patients.