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目的:探讨预先结扎髂内动脉分支在减少腹腔镜根治性膀胱切除术中出血的临床可行性。方法:2008年12月～2012年11月采用预先结扎双侧髂内动脉分支的方法对26例T2～T3期膀胱癌患者进行腹腔镜根治性膀胱切除术。结果:26例手术均获成功,根治手术时间160～210min,平均(187±20)min。术中出血60～350ml,平均(192±55)ml。随访2～12个月,所有患者均未出现臀部疼痛、臀肌萎缩以及间歇性跛行等臀肌缺血并发症。结论:腹腔镜根治性膀胱切除术中预先结扎壁支远端的髂内动脉干或分支,可有效减少术中出血,使手术的操作更精准,不会引起臀肌缺血的相关并发症。
Objective: To investigate the clinical feasibility of pre-ligating the branch of internal iliac artery in reducing the bleeding during laparoscopic radical cystectomy. Methods: From December 2008 to November 2012, 26 patients with T2 ~ T3 bladder cancer underwent laparoscopic radical cystectomy by means of pre-ligation of bilateral branches of internal iliac artery. Results: Twenty - six cases were successful. The radical operation time was 160 ~ 210min with an average of (187 ± 20) min. Intraoperative bleeding 60 ~ 350ml, mean (192 ± 55) ml. All the patients were followed up for 2 to 12 months without hip pain, gluteal muscle atrophy and intermittent claudication of gluteal ischemia complications. Conclusions: Laparoscopic radical cystectomy with ligation of the internal iliac artery or branch distal to the distal branch of the wall can effectively reduce the intraoperative bleeding and make the operation more precise, and will not cause the related complications of gluteal ischemia.