| Objective To compare the efficacy of laparoscopic radical cystectomy with ileal orthotopic neobladder via extraperitoneal and transperitoneal approach.Methods The clinical data of61 patients with bladder cancer who underwent laparoscopic radical cystectomy with ileal orthotopic neobladder for bladder cancer from April 2018 to December 2020 were analyzed retrospectively.They were divided into two groups: extraperitoneal approach and transperitoneal approach according to the mode of operation.In the extraperitoneal group,there were 20 males and 6 females.In the transabdominal group,there were 26 males and 9females.We collected the data of postoperative complications,used Clavien system classification,compared the incidence of postoperative complications between the two groups,and compared the perioperative results between the two groups.Results The operation time was(259.44±49.84)min in the extraperitoneal group and(237.09±45.32)min in the transperitoneal group,and the hospitalization cost was(67251.03±10360.60)yuan and(73128.19±18388.72)yuan,respectively.The intraoperative blood loss was(112.9±31.56)ml and(122±29.89)ml,and the number of lymph node dissection was(15.11±6.19)and(13.36±4.32),respectively,The difference was not statistically significant(P>0.05).The postoperative hospital stay was(13.78 ±4.60)d and(20±6.29)d,respectively.During the90-day follow-up,there was a significant difference in the incidence of postoperative complications between 11(42.31%)and 27(77.14%),the incidence of paralytic ileus was 3(1.54%)and14(40.00%),and the incidence of postoperative complications was6(46.2%)and29(82.8%)(P<0.05).Conclusion Laparoscopic extraperitoneal radical cystectomy with ileal orthotopic neobladder can reduce the incidence of postoperative complications,shorten postoperative hospital stay,speed up the recovery of patients,and is safe and reliable,which is worthy of further promotion. |
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