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Eur Uro：ERAS方案应用于根治性膀胱切除术中的优点。

2017-08-11 fengxiangxin MedSci原创

根治性膀胱切除术术后康复术中失血住院时间ERAS
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促进术后恢复（enhanced recovery after surgery，ERAS）方案，是一种多模式的围手术期综合诊疗路径。其目的是通过对手术进行风险评估和干预，优化治疗共存病症包括心血管、呼吸系统和/或肾脏疾病，同时治疗和维持患者在围手术期重要脏器官的功能，了解和处理患者存在的社会和行为因素，比如非法药物的使用情况以及对烟草和酒精的依赖等等，减少术中和术后患者身体对外科手术的严重应激反应。

促进术后恢复（enhanced recovery after surgery，ERAS）方案，是一种多模式的围手术期综合诊疗路径。其目的是通过对手术进行风险评估和干预，优化治疗共存病症包括心血管、呼吸系统和/或肾脏疾病，同时治疗和维持患者在围手术期重要脏器官的功能，了解和处理患者存在的社会和行为因素，比如非法药物的使用情况以及对烟草和酒精的依赖等等，减少术中和术后患者身体对外科手术的严重应激反应。这个计划以往主要用于结直肠手术、血管外科手术、胸外科手术的病人，近年来也扩大到根治性膀胱手术的病人。多模式ERAS的应用明显改善了结直肠手术的疗效，为了进一步探讨该方案在泌尿外科中的应用价值，研究者收集了在单一机构连续行RC患者的相关结果。控制因素包括：组成康复训练的26个部分、同一天入院、碳水化合物负荷、术中液体复苏、区域麻醉、鼻胃管的停用、不做口服法肠道准备、今早去除导尿管的使用、动员尽早下地活动、嚼口香糖和审查。共有453位连续接受RC的患者，其中393（87%）位实施了ERAS方案。实施了ERAS方案的患者相比没有实施的患者，住院时间缩短了（中位数[间距范围]：8 [ 6-13 ]天

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    2017-09-28 doctorzheng

    #切除术#

    0

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    2017-12-20 124988c7m106暂无昵称

    #ERA#

    0

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    2018-05-05 12498710m11暂无昵称

    #根治性膀胱切除术#

    0

  4. 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level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-13 tonychen24

    #膀胱切除术#

    0

  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Fri Aug 11 23:41:54 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232582, encodeId=3f9f2325823f, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Aug 11 22:33:43 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232581, encodeId=076b232581de, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-13 jeanqiuqiu

    #根治#

    0

  6. 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level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-13 1e10c84am36(暂无匿称)

    文章不错，赞赞赞

    0

  7. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Fri Aug 11 23:41:54 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232582, encodeId=3f9f2325823f, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Aug 11 22:33:43 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232581, encodeId=076b232581de, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-12 忠诚向上

    好好看下，实用

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Fri Aug 11 23:41:54 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232582, encodeId=3f9f2325823f, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Aug 11 22:33:43 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232581, encodeId=076b232581de, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-11 林3301

    不错学习下

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Aug 13 05:57:52 CST 2017, time=2017-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232712, encodeId=e8b0232e1249, content=好好看下，实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sat Aug 12 06:44:39 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232616, encodeId=d524232616bf, content=不错学习下, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Fri Aug 11 23:41:54 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232582, encodeId=3f9f2325823f, content=学习一下很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Fri Aug 11 22:33:43 CST 2017, time=2017-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232581, encodeId=076b232581de, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-11 1771ae4158m

    学习一下很不错

    0

  10. 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level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Aug 11 22:33:10 CST 2017, time=2017-08-11, status=1, ipAttribution=)]
    2017-08-11 orangesking

    学习

    0

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根治性膀胱切除术后发生尿道癌的危险因素分析

目前，膀胱肿瘤的发病率已居我国男性恶性肿瘤的第7位，对于MIBC、高危膀胱癌等的标准手术方式是根治性膀胱切除术，但术后部分患者会发生尿道癌。众多研究报道，根治性膀胱切除术后尿道癌的发生率为0～18%。Stenzl等的荟萃分析结果显示，根治性膀胱切除术后尿道癌的发生率约为8.1%。本组350例患者术后尿道癌发生率为8%，与文献报道相符。既往NMIBC病史是根治性膀胱切除术后尿道癌复发的独立危险因素。

BJU INT：BMI指数较高的患者行机器人辅助腹腔镜根治性膀胱切除术和体内尿流改道术预后如何？

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