Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2010
[Laparoendoscopic single-site surgery radical cystectomy with orthotopic taenia myectomy sigmoid neobladder: initial report].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Liu Chun-xiao, Xu A-bai, Chen Bin-shen, Zheng Shao-bo, Li Hu-lin, Xu Ya-wen
Аннотация
OBJECTIVE: To report the first case and detailed techniques of laparoendoscopic single-site surgery (LESS) radical cystectomy with orthotopic taenia myectomy sigmoid neobladder for organ-confined bladder cancer.
METHODS: A 74-year-old man presented with gross hematuria for 2 months and biopsy revealed bladder cancer. LESS radical cystectomy and bilateral pelvic lymphadenectomies were performed using a single multilumen port inserted through a solitary 3.5 cm lower abdominal incision with conventional laparoscopic instruments. The taenia myectomy sigmoid pouch was then constructed by open procedure.
RESULTS: The total operative time was 9.5 h, and the LESS procedure lasted for about 5.5 h. No other port incision was added. The final pathology revealed urothelial carcinoma. The estimated intraoperative blood loss was 600 ml with blood transfusion of 400 ml. The pelvic lymph nodes and the surgical margins of the ureters and urethra were all free of tumor invasion. No water electrolyte and metabolic acid-base balance disorders were observed perioperatively. The neobladder capacity was about 280 ml, with a residual urine volume of 10 ml and peak flow rate of 11.1 ml/s 3 months postoperatively.
CONCLUSION: Although with a steep learning curve, LESS surgery can be a less invasive and promising alternative to muscle-invasive bladder carcinoma.
METHODS: A 74-year-old man presented with gross hematuria for 2 months and biopsy revealed bladder cancer. LESS radical cystectomy and bilateral pelvic lymphadenectomies were performed using a single multilumen port inserted through a solitary 3.5 cm lower abdominal incision with conventional laparoscopic instruments. The taenia myectomy sigmoid pouch was then constructed by open procedure.
RESULTS: The total operative time was 9.5 h, and the LESS procedure lasted for about 5.5 h. No other port incision was added. The final pathology revealed urothelial carcinoma. The estimated intraoperative blood loss was 600 ml with blood transfusion of 400 ml. The pelvic lymph nodes and the surgical margins of the ureters and urethra were all free of tumor invasion. No water electrolyte and metabolic acid-base balance disorders were observed perioperatively. The neobladder capacity was about 280 ml, with a residual urine volume of 10 ml and peak flow rate of 11.1 ml/s 3 months postoperatively.
CONCLUSION: Although with a steep learning curve, LESS surgery can be a less invasive and promising alternative to muscle-invasive bladder carcinoma.