目的：探讨膀胱大部分切除一期行生物补片膀胱修补术在高龄浸润性膀胱癌患者中的临床疗效和安全性。方法：回顾性分析2016年10月至2017年3月在北京大学人民医院泌尿外科行膀胱部分切除、一期行生物补片膀胱修补术的2例患者的临床资料。病例1，87岁老年男性，膀胱前壁病变，范围5.5 cm×2.5 cm，美国麻醉医师协会（American Society of Anesthesiologists, ASA）病情分级Ⅲ级。病例2，77岁老年女性，膀胱右前壁病变，范围5.2 cm×4.0 cm，ASA Ⅱ级。患者采用膀胱大部分切除生物补片膀胱扩大的手术方式，记录手术时间、术中出血量、围术期手术资料及术后膀胱镜及尿动力学随访情况。结果：2例均顺利完成手术，平均手术时间（155.0±35.4）min，术中出血量20~100 mL，患者均在术后8 d出院。术后随访10~14个月，均未发现肿瘤复发和转移。随访尿动力结果：最大尿流率16.5 mL/s，最大膀胱容量303 mL。白天3~4次，夜尿0~3次，排尿间隔2 h，每次尿量200~300 mL，美国泌尿外科协会症状评分(American Urological Association symptom score, AUASS) 2~5分。对于高龄、合并症多、手术麻醉风险大的患者可以行膀胱部分切除，以减少并发症的发生。肿瘤体积小的患者，膀胱部分切除后能够保留足够的正常膀胱壁，并逐渐恢复膀胱容量。对于病变范围较大、残余正常膀胱组织较少的患者，保证切缘阴性的情况下，膀胱扩大术有助于恢复膀胱容量。结论：膀胱大部分切除一期行生物补片膀胱修补术有较高的安全性，可以保留膀胱功能，提高生活质量，适用于高龄浸润性膀胱癌患者。

Objective： To evaluate the clinical effect and safety of biological patch applied in elderly patients with invasive bladder cancer who underwent massive partial cystectomy with augmentation cystoplasty. Methods: The clinical data of 2 patients with invasive bladder cancer from October 2016 to March 2017, who underwent the massive partial cystectomy with augmentation cystoplasty were retrospectively reviewed. Case one was an 87-year-old man, with tumor located on the bladder anterior wall, ranging from 5.5 cm×2.5 cm, and the grade of American Society of Anesthesiologists (ASA) being Ⅲ. Case two was a 77-year-old female, whose lesion was located on the right anterior wall, ranging from 5.2 cm×4.0 cm, and the grade of ASA being Ⅱ. Both of the patients received a massive partial cystectomy with augmentation cystoplasty. The operative time, estimated blood loss, perioperative and postoperative data and follow-up data, including cystoscopy and urodynamics were recorded and compared. When the P value was less than 0.05, it was statistically significant. Results: All the operations were successfully performed. The average operative time was (155.0+35.4)  min, mean estimated intraoperative blood loss was 20 to 100 mL, and the mean postoperatively hospital stay was eight days. During the 10 to 14 months’ follow-up periods, no local recurrence or distant metastasis occurred. Urodynamic data: the maximum urinary flow rate was 16.5 mL/s, and the maximum bladder capacity was 303 mL. The two patients urinated 3-4 times in the day time, 0 to 3 times in the night, 200-300 mL each time, on average. The American Urological Association symptom score was 3 to 5. Partial cystectomy, applied to aged patients with multiple complications and high risk of surgical anesthesia, was able to reduce surgery rela-ted complications. For patients with tumor of small size, the normal bladder wall would be enough to reco-ver functional capacity for urine storing after partial cystectomy. For patients with large lesions range and small normal bladder tissues, augmentation cystoplasty would help recover bladder capacity on the condition of negative margin. Conclusion: Massive partial cystectomy with augmentation cystoplasty is safe and effective. It could decrease perioperative morbidity and keep the quality-of-life benefits of bladder preservation, which is worthy of further application for some selected invasive bladder cancer in elderly patients.