根治性膀胱切除术术前肠道准备的研究进展

doi:10.16460/j.issn1008-9969.2020.20.027

摘要/Abstract

摘要： 目的通过对有关根治性膀胱切除术术前肠道准备类型及其与术后并发症关系的文献复习,探讨术前肠道准备是否可降低患者术后并发症的发生率,为患者的术前准备提供参考。方法对国内外所有涉及根治性膀胱切除术患者术前肠道准备的文献进行内容归纳、梳理、总结。结果根治性膀胱切除术前肠道准备方案有3种：机械性肠道准备、限制性肠道准备、无肠道准备;患者术后并发症主要有3大类：感染相关性并发症、肠功能相关并发症以及伤口并发症,其与患者的组织灌注量及身体状况、营养等密切相关。结论在现有研究的基础上,可认为机械性肠道准备在降低患者术后并发症的发生率、缩短住院时间上并无任何优势,在手术准备条件充足、灭菌严格的情况下可取消术前机械性肠道准备。但是否术前口服抗菌药物缺乏明确标准,不能排除环境因素及手术因素对术后并发症的影响,故有待未来继续深入研究。

中图分类号:

R473.6

彭瑶瑶, 师正燕, 李晓玲. 根治性膀胱切除术术前肠道准备的研究进展[J]. 护理学报, 2020, 27(20): 27-31.

参考文献

[1] Han KS,Ami Y,Hyun JJ,et al.Incidence and Risk Factors of 30-day Early and 90-day Late Morbidity and Mortality of Radical Cystectomy During a 13-year Follow-up:A Comparative Propensity-score Matched Analysis of Complications between Neobladder and Ileal Conduit[J].Jpn J Clin Oncol,2014,44(7):677-685.DOI:10.1093/jjco/hyu051.
[2] Anderson CB,McKiernan JM.Surgical Complications of Urinary Diversion[J].Urol Clin N Am,2018,45(1):79-90.DOI:10.1016/j.ucl.2017.09.008.
[3] Wang DS.Re:90-day Complication Rate in Patients Undergoing Radical Cystectomy with Enhanced Recovery Protocol:A Prospective Cohort Study[J].J Urology,2018,200(4):674.DOI:10.1016/j.juro.2018.06.040.
[4] Hautmann RE,Hautmann SH,Hautmann O.Complications Associated with Urinary Diversion[J].Nat Rev Urol,2011,8(12):667-677.DOI:10.1038/nrurol.2011.147.
[5] Kalogera E,Houten HKV,Sangaralingham LR,et al.Use of Bowel Preparation Does Not Reduce Post-Operative Infectious Morbidity Following Minimally Invasive or Open Hysterectomies[J].Gynecol Oncol,2019,153(3):e20-e21.DOI:10.1016/j.ygyno.2019.03.153.
[6] Yang L,Chen HS,Welk B,et al.Does Using Comprehensive Preoperative Bowel Preparation Offer Any Advantage for Urinary Diversion Using Ileum?A Meta-analysis[J].Int Urol Nephrol,2013,45(1):25-31.DOI:10.1007/s11255-012-0319-5.
[7] Deng S,Dong Q,Wang J,et al.The Role of Mechanical Bowel Preparation before Ileal Urinary Diversion:A Systematic Review and Meta-analysis[J].Urol Int,2014,92(3):339-348.DOI:10.1159/000354326.
[8] Xu R,Zhao X,Zhong Z,et al.No Advantage Is Gained by Preoperative Bowel Preparation in Radical Cystectomy and Ileal Conduit:A Randomized Controlled Trial of 86 Patients[J].Int Urol Nephrol,2010,42(4):947-950.DOI:10.1007/s11255-010-9732-9.
[9] Shafii M,Murphy DM,Donovan MG,et al.Is Mechanical Bowel Preparation Necessary in Patients Undergoing Cystectomy and Urinary Diversion?[J].BJU Int,2002,89(9):879-881.DOI:10.1046/j.1464-410X.2002.02780.x.
[10] Cao F,Li J,Li F.Mechanical Bowel Preparation for Elective Colorectal Surgery:Updated Systematic Review and Meta-Analysis[J].Int J Colorectal Dis,2012,27(6):803-810.DOI:10.1007/s00384-011-1361-y.
[11] Hashad MME,Atta M,Elabbady A,et al.Safety of No Bowel Preparation before Ileal Urinary Diversion[J].BJU Int,2012,110(11c):E1109-E1113.DOI:10.1111/j.1464-410X.2012.11415.x
[12] Buia A,Post S,Buhr HJ,et al.Darmvorbereitung bei elektiven kolorektalen Resektionen in Deutschland 2017[J].Der Chirurg,2019,90(7):564-569.DOI:10.1007/s00104-018-0773-4.
[13] Aslan G,Baltaci S,Akdogan B,et al.A Prospective Randomized Multicenter Study of Turkish Society of Urooncology Comparing Two Different Mechanical Bowel Preparation Methods for Radical Cystectomy[J].Urol Oncol Semin Ori,2013,31(5):664-670.DOI:10.1016/j.urolonc.2011.03.009.
[14] Pruthi RS,Chun J,Richman M.Reducing Time to Oral Diet and Hospital Discharge in Patients Undergoing Radical Cystectomy Using a Perioperative Care Plan[J].Urology,2003,62(4):660-665.DOI:10.1016/s0090-4295(03)00651-4.
[15] Zaid HB,Kaffenberger SD,Chang SS.Improvements in Safety and Recovery Following Cystectomy:Reassessing the Role of Pre-operative Bowel Preparation and Interventions to Speed Return of Post-operative Bowel Function[J].Curr Urol Rep,2013,14(2):78-83.DOI:10.1007/s11934-012-0300-y.
[16] Heher EC,Thier SO,Rennke H,et al.Adverse Renal and Metabolic Effects Associated with Oral Sodium Phosphate Bowel Preparation[J].Clin J Am Soc Nephrol,2008,3(5):1494-1503.DOI:10.2215/CJN.02040408.
[17] Tabibi A,Simforoosh N,Basiri A,et al.Bowel Preparation Versus No Preparation Before Ileal Urinary Diversion[J].Urology,2007,70(4):650-658.DOI:10.1016/j.urology.2007.06.1107.
[18] Raynor MC,Lavien G,Nielsen M,et al.Elimination of Preoperative Mechanical Bowel Preparation in Patients Undergoing Cystectomy and Urinary Diversion[J].Urol Oncol-Semin Ori,2013,31(1):32-35.DOI:10.1016/j.urolonc.2010.11.002.
[19] Casans-Francés R,Roberto-Alcácer AT,García-Lecina AC,et al.Impact of An Enhanced Recovery after Surgery Programme in Radical Cystectomy.A Cohort-comparative Study[J].Revista Espaola De Anestesiología Y Reanimación,2017,64(6):313-322.DOI:10.1016/j.redare.2016.12.005.
[20] Wei CHX,Wan FCH,Zhao HW,et al.Application of Enhanced Recovery after Surgery in Patients Undergoing Radical Cystectomy[J].J Int Med Res,2018,46(12):5011-5018.DOI:10.1177/0300060518789035.
[21] Koscielny A,Engel D,Maurer J,et al.The Role of Lymphoid Tissue in the Attenuation of the Postoperative Ileus[J].Am J Physiol Gastrointest Liver Physiol,2013,304(4):G401-G412.DOI:10.1152/ajpgi.00161.2012.
[22] Djaladat H,Daneshmand S.Gastrointestinal Complications in Patients Who Undergo Radical Cystectomy with Enhanced Recovery Protocol[J].Curr Urol Rep,2016,17(7):1-6.DOI:10.1007/s11934-016-0607-1.
[23] Mir MC,Zargar H,Bolton DM,et al.Enhanced Recovery after Surgery Protocols for Radical Cystectomy Surgery:Review of Current Evidence and Local Protocols[J].Anz J Surg,2015,85(7/8):514-520.DOI:10.1111/ans.13043.
[24] Daneshmand S,Ahmadi H,Schuckman AK,et al.Enhanced Recovery Protocol after Radical Cystectomy for Bladder Cancer[J].J Urol,2014,192(1):50-56.DOI:10.1016/j.juro.2014.01.097.
[25] Hewitt J,Reeve J,Rigby J,et al.Whole-gut Irrigation in Preparation for Large Bowel Surgery[J].Lancet,1973,302(7825):337-340.DOI:10.1016/S0140-6736(73)93189-9.
[26] Baack Kukreja JEB,Messing EM,Shah JB,et al.Are We Doing “Better”? The Discrepancy between Perception and Practice of Enhanced Recovery after Cystectomy Principles among Urologic Oncologists[J].Urol Oncol-Semin Qri,2016,34(3):120.e17-120.e21.DOI:10.1016/j.urolonc.2015.10.002.
[27] Oedorf K,Skaaheim HE,Liedberg F,et al.Perioperative Management of Radical Cystectomy in the Nordic Countries[J].Scandinav J Urol,2019:1-5.DOI:10.1080/21681805.2019.1583686.
[28] Aslan G,Baltaci S,Cal C,et al.Bowel Preparation and Peri-operative Management for Radical Cystectomy in Turkey:Turkish Urooncology Association Multicenter Survey[J].Urol J,2011,8(2):113-119.DOI:10.3747/pdi.2010.00102.
[29] Witjes JA,Compérat Eva,Cowan NC,et al.EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer:Summary of the 2013 Guidelines[J].Eur Urol,2014,65(4):778-792.DOI:10.1016/j.eururo.2013.11.046.
[30] Witjes JA,Lebret T,Compérat Eva M,et al.Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer[J].Eur Urol,2017,71(3):462-475.DOI:10.1016/j.eururo.2016.06.020.
[31] Kassouf W,Aprikian A,Black P,et al.Recommendations for the Improvement of Bladder Cancer Quality of Care in Canada:A Consensus Document Reviewed and Endorsed by Bladder Cancer Canada (BCC),Canadian Urologic Oncology Group(CUOG),and Canadian Urological Association (CUA),December 2015[J].Cuaj-Can Urol Assoc,2016,10(1/2):E46.DOI:10.5489/cuaj.3583.

Metrics

Viewed

Full text

Abstract

Cited

Shared