摘要
目的:报告完全腹腔镜下保留前列腺尖部后包膜的根治性膀胱切除并回肠原位新膀胱(posterior capsule of prostatic apex sparing laparoscopic radical cystectomy and intracorporeal orthotopic neobladder,PCPAS-LRC-ICONB)-(Studer术式)围手术期结果及短期疗效。方法:回顾性分析2019年7月至2023年7月天津医科大学第二医院和淮安市淮安医院行PCPAS-LRC-ICONB(Studer术式)的男性患者34例,总结PCPAS-LRC-ICONB的围手术期及短期结果。结果:全部34例患者均完成了PCPAS-LRCICONB,新膀胱-尿道吻合在无张力状态下进行,无中转开放病例,中位手术时间:420(350~520)min,中位失血量约200(150~600)m L,中位随访时间22.5(4.0~60.0)个月,围手术期未出现Clavien 3级及以上并发症,术后12个月,日间尿控率88.9%,夜间尿控率66.7%,所有患者对尿控情况满意,中位膀胱容量225(100~400)mL,中位残余尿量20(0~50)mL。术后2例患者分别于6个月及15个月发现肺转移,2例患者分别于术后18个月及25个月发现骨转移,1例患者出现肝转移,2例患者出现局部复发(1例腹壁种植)。至随访结束时共计有1例患者死于脑梗,1例患者死于心梗,1例患者死于其他意外,6例患者死于膀胱癌复发和(或)转移。结论:PCPAS-LRC-ICONB-(Studer术式)降低了新膀胱-尿道吻合难度,围手术期及术后短期结果满意。
Objective:To report the perioperative outcomes and short-term efficacy of posterior capsule of prostatic apex sparing laparoscopic radical cystectomy and intracorporeal orthotopic neobladder(PCPAS-LRC-ICONB),also known as the Studer technique.Methods:A retrospective analysis was conducted on 34 male patients who underwent PCPAS-LRC-ICONB between July 2019 and July 2023 at Huai’an Hospital of Huai’an City and Tianjin Medical University Second Hospital.The perioperative and short-term outcomes of PCPAS-LRC-ICONB were summarized.Results:All 34 patients completed the PCPAS-LRC-ICONB procedure successfully.Neobladder-urethral anastomosis was performed without tension,and no cases required conversion to open surgery.The median operative time was 420 min(range 350–520 min),with a median estimated blood loss of 200 mL(range 150–600 mL).The median follow-up time was 22.5 months(range 4–60 months).No complications of Clavien grade three or higher occurred during the perioperative period.At 12 months postoperatively,the daytime and nighttime urinary continence rates were 88.9%and 66.7%,respectively.All the patients were satisfied with their urinary continence status.The median bladder capacity was 225 mL(range 100–400 mL)and the median residual urine volume was 20 mL(range 0–50 mL).Pulmonary metastases were detected in two patients at 6 and 15 months postoperatively,bone metastases in two patients at 18 and 25 months,liver metastasis in one patient,and local recurrence(one case of abdominal wall implantation)in two patients.By the end of the follow-up period,one patient died from cerebral infarction,one from myocardial infarction,one from other accidents,and six patients died from bladder cancer recurrence and/or metastasis.Conclusions:PCPAS-LRC-ICONB reduced the difficulty of neobladder-urethral anastomosis,and the perioperative and short-term outcomes were satisfactory.
作者
宗大朋
徐鑫
颜凯
潘杰
周吉芝
姜行康
马宝杰
Dapeng Zong;Xin Xu;Kai Yan;Jie Pan;Jizhi Zhou;Xingkang Jiang;Baojie Ma(Department of Urology,Huai'an Hospital of Huai'an City,Huai'an 223200,China;Department of Urology,Tianjin Medical University Second Hospital,Tianjin 300211,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2024年第20期1044-1048,共5页
Chinese Journal of Clinical Oncology
基金
江苏护理职业学院医教融合项目(编号:SHKRB2303,SHKRD2308,SHKRD2309)资助。
关键词
膀胱癌
根治性膀胱切除
回肠原位新膀胱
bladder carcinoma
laparoscopic radical cystectomy
intracorporeal orthotopic neobladder(ICONB)
