评价标准化设计进行腹腔镜膀胱根治性切除-原位回肠新膀胱术的安全性和有效性。

2014年7月至2016年10月，安徽医科大学第二附属医院的34例(其中男性32例、女性2例)膀胱癌患者按标准化流程接受腹腔镜膀胱根治性切除-原位回肠新膀胱术，收集并分析患者的基本资料、围手术期结果、术后并发症、病理结果及生存状况。

患者平均年龄65.5岁(48～79岁),所有患者手术均顺利完成，无中转开放手术及添加套管患者。平均手术时间352 min(295～436 min),平均出血量112 ml(50～350 ml)。术后30 d内并发症：Clavien Ⅰ-Ⅱ级12例，Clavien Ⅲ-Ⅴ级4例。平均清扫淋巴结14.5枚，16.7%患者淋巴结阳性。术后病理显示：3例T1N0G3，6例T2aN0, 11例T2bN0, 2例T2bN1, 5例T3aN0，4例T3aN1，3例T3bN0，手术切缘均为阴性。患者对术后外观满意。中位随访时间为24个月(2～48个月)，其中1例患者术后因肠梗阻转入普外科，无局部复发患者，2例患者于术后12、15个月发现远处转移行化疗，患者均健在。术后6个月，患者白天均能达到良好控尿，其中6例患者夜间不能自主控尿。

标准化流程腹腔镜膀胱根治性切除-原位回肠新膀胱技术可行，近期肿瘤根治效果良好，远期疗效及肿瘤控制效果仍有待更长期的大样本研究。

To investigate the safety and efficacy of standardized design for laparoscopic cystectomy with orthotopic ileal neobladder (LRC-OIN) for bladder cancer.

From Jul. 2014 to Oct. 2016, 34 patients with bladder cancer underwent standardized design LRC-OIN at our hospital and were enrolled in this study. The patients′ information, postoperative complications, pathologic characteristics, and survival data were collected and analysed.

The average age of patients was 65.5 years (48-79 years). All patients were successfully operated without conversion to open surgery or adding trocars. The average operation time was 352 min (295-436 min), and the average bleeding volume was 112 ml (50-350 ml). The postoperative complications within 30 days, Clavien Ⅰ-Ⅱ12 were cases, Clavien Ⅲ-V 4 were cases. The mean of lymph node dissection was 14.5, and lymph node positive percentage was 16.7%. Postoperative pathology showed 3 cases were T1N0G3, 6 cases were T2aN0, 11 cases were T2bN0, 2 cases were T2bN1, 5 cases were T3aN0, 4 cases were T3aN1, 3 cases were T3bN0. All surgical margins were negative. Patients were satisfied with postoperative appearance. The median follow-up time was 24 months (2-48 months), 1 patient with postoperative intestinal obstruction was transferred to the Department of general surgery. All patients were alive. No local recurrence cases. 2 patients were underwent chemotherapy who were found distant metastasis at 12 and 15 months after surgery. Patients could achieve good continence during the day 6 months after operation, and 6 patients could not control urine at night.

Standardized design laparoscopic radical cystectomy with orthotopic ileal neobladder was technically feasible. Our data has shown the recent oncological outcome is well. The outcome may need a long-term large sample study to further elaborate.