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四肢瘫痪患者成功实施全机器人腹腔镜膀胱前列腺切除术及回肠膀胱术的初步经验:两例报告

Initial experience with successful totally robotic laparoscopic cystoprostatectomy and ileal conduit construction in tetraplegic patients: report of two cases.

作者信息

Hubert Jacques, Chammas Mario, Larre Stephane, Feuillu Benoit, Cheng Fan, Beis Jean-Marie, Coissard Alain, Andre Jean Marie

机构信息

Service d'Urologie, CHU de Nancy-Brabois, Nancy, France.

出版信息

J Endourol. 2006 Feb;20(2):139-43. doi: 10.1089/end.2006.20.139.

Abstract

PURPOSE

To evaluate the feasibility and safety of totally robotic laparoscopic cystoprostatectomy for neurogenic bladder, with intracorporeal ileal-conduit urinary diversion in tetraplegic patients with severe neurogenic bladder complications.

PATIENTS AND METHODS

Two men, 41 and 38 years old, with complete post-traumatic C7-C8 quadriplegia and poor lower urinary-tract condition underwent totally transperitoneally performed cystoprostatectomy and ileal-conduit urinary diversion with robotic assistance (Da Vinci).

RESULTS

The procedures were completed without open conversion. The total surgical time was 9.25 and 6.75 hours, respectively. There were no intraoperative complications. In the postoperative period, both patients had mild complications (pulmonary and urinary infections) that were treated successfully medically. The postoperative hospital stay was 13 days in both cases.

CONCLUSIONS

Our results demonstrate the safety and feasibility of robot-assisted laparoscopic cystoprostatectomy with ileal-conduit urinary diversion in two tetraplegic patients.

摘要

目的

评估全机器人腹腔镜膀胱前列腺切除术治疗神经源性膀胱的可行性和安全性,该手术采用体内回肠代膀胱术式,用于患有严重神经源性膀胱并发症的四肢瘫痪患者。

患者与方法

两名男性患者,年龄分别为41岁和38岁,均为创伤后C7 - C8完全性四肢瘫痪,下尿路状况较差,接受了全经腹机器人辅助(达芬奇)膀胱前列腺切除术及回肠代膀胱术。

结果

手术均未中转开腹完成。总手术时间分别为9.25小时和6.75小时。术中无并发症发生。术后,两名患者均出现轻度并发症(肺部和泌尿系统感染),经药物治疗成功治愈。两例患者术后住院时间均为13天。

结论

我们的结果证明了机器人辅助腹腔镜膀胱前列腺切除术联合回肠代膀胱术在两名四肢瘫痪患者中的安全性和可行性。

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