机器人辅助单孔腹腔镜下全膀胱全尿道切除术治疗膀胱癌合并尿道癌一例并文献复习

Robot-assisted single-site laparoscopic radical cysto-urethrectomy for bladder cancer complicated with urethral cancer:a case report and literature review

目的:评价膀胱癌合并尿道癌的患者行机器人辅助单孔腹腔镜全膀胱全尿道切除术的必要性、可行性及优势。方法:南京中医药大学附属医院收治1例膀胱癌合并尿道癌患者,排除手术禁忌证后行机器人辅助单孔腹腔镜全膀胱全尿道切除术+盆腔淋巴结清扫,结合相关文献并讨论。结果:患者总手术时间为240 min,机器人操作时间为190 min,备机时间为15 min,术中出血量为100 ml。手术过程顺利,无中转常规腹腔镜或开放手术,无并发症发生,术后15 d出院。术后大病理标本切缘阴性,未见转移淋巴结。结论:机器人辅助单孔腹腔镜全膀胱全尿道切除术治疗膀胱癌合并尿道癌的手术效率更高,瘤控更佳,操作更简便、精细,安全性更高,临床疗效值得肯定。

Objective:To evaluate the necessity,feasibility and advantages of robot-assisted single-site laparoscopic radical cysto-urethrectomy in patients with bladder cancer complicated with urethral cancer.Methods:A case of bladder cancer complicated with urethral cancer was admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine.After excluding the contraindications of surgery,robot-assisted single-site laparoscopic radical cysto-urethrectomy+pelvic lymph node dissection was performed.This case is discussed in this paper combined with relevant literature.Results:The total operative time was 240 min,with 190 min of robotic operation time and 15 min of standby time.The intraoperative blood loss was 100 ml.The surgery was successfully completed without conversion to laparoscopic or open surgery,and no complications occurred.The patient was discharged 15 days after surgery.Postoperative resection margin of pathological specimens was negative and no metastatic lymph nodes were found.Conclusion:Robot-assisted single-site laparoscopic total vesical radical cysto-urethrectomy in the treatment of bladder cancer complicated with urethral cancer has higher surgical efficiency,better tumor control,more simple and precise operation,higher safety,and worthy of positive efficacy.