机器人根治性膀胱切除术后回肠-新膀胱瘘并右输尿管狭窄一例报告

Entero-neovesical fistula with concurrent ureterointestinal anastomotic stricture after robotic assisted radical cystectomy:a case report

根治性膀胱切除术+原位回肠新膀胱是治疗肌层浸润性膀胱癌和高危非肌层浸润性膀胱癌的金标准,但手术步骤繁琐,并发症发生率很高。本文报告1例,男,50岁。机器人根治性膀胱切除术后3个月出现粪尿,诊断为回肠-新膀胱瘘和右输尿管新膀胱吻合口狭窄。膀胱镜检查见新膀胱顶壁瘘口直径5 mm。应用机器人辅助腹腔镜行回肠-新膀胱瘘修补+右输尿管新膀胱再植术。术后随访4个月余,效果满意。

Radical cystectomy and orthotopic neobladder reconstruction is the gold standard for the treatment of muscle invasive bladder cancer and high-risk non-muscle invasive bladder cancer.The procedure is complicated and the complication rate is very high.A case of Entero-neovesical fistula(ENF)with concurrent ureterointestinal anastomotic stricture(UAS)after robot-assisted radical cystectomy(RARC)was reported.The patient,male,50 years old,had fecaluria 3 month after RARC.Cystoscopy revealed a 5 mm fistula on the apex of the neobladder.Robot assisted laparoscopic exploration and repair of ENF and right reimplantation of the right ureter to the neobladder were performed.The results was satisfactory after more than 4 months of follow-up.