ABSTRACT
Objective:To examine the overall benefits of laparoscopy combined with cystoscopy for the treatment of elderly patients with intraperitoneal bladder rupture, in order to provide recommendations for establishing the optimal treatment regimen for elderly patients with intraperitoneal bladder rupture.Methods:A retrospective analysis was conducted, with clinical data of 31 elderly patients with intraperitoneal bladder rupture(Group A)who received laparoscopic repair at our hospital between July 2017 and March 2020.Group B included 32 elderly patients with intraperitoneal bladder rupture who received repair with laparoscopy combined with cystoscopy during the same period at our hospital.Complete medical records, treatment data and examination data of all patients were available for analysis.Results from perioperative indexes, including activities of daily living(ADL)scores before the procedure and after the follow-up and postoperative complications, were compared between the two groups.Results:Compared with Group A, Group B had a shorter total operation time(106.5±10.2)min vs.(123.3±10.4)min and a shorter hospitalization time(6.2±1.4)d vs.(8.7±1.6)d, with statistically significant differences( t=6.444 and 6.583, P<0.001). The amount of bleeding[46.4(46.4~47.5)]ml vs.[45.7(41.3~47.5)ml, U=1.905, P=0.057], time to first passage of flatus[(2.4±1.1)h vs.(2.7±1.1)h, t=0.874, P=0.386]and time to drainage tube removal[(4.2±0.8)d vs.(4.3±0.8)d, t=0.619, P=0.539]showed no statistically significant differences between the two groups.Group B had a preoperative ADL score of 52.3(51.9, 53.3)and a post-follow-up score of 75.9(75.3, 76.4), while Group A had a pre-operative score of 52.2(51.2, 53.2)and a post-follow-up score of 65.6(64.6, 68.8). At the end of the follow-up, ADL scores of both groups were higher than those before the procedure(Group B: Z=6.832, Group A: Z=6.769, P<0.01), but ADL scores in Group B were higher than in Group A, with statistical significance( Z=6.653, P<0.001); The two groups had no statistical difference in total incidence of complications(12.50% vs.16.12%, χ2=0.003, P=0.959). Conclusions:Compared with laparoscopy alone, laparoscopy combined with cystoscopy can shorten the operation time and promote postoperative rehabilitation for the treatment of elderly patients with intraperitoneal bladder rupture and improve activities of daily living of patients, without increasing the risk of complications, indicating good safety.