Ferron Gwénaël, Lim Timothy Yong Kuei, Pomel Christophe, Soulie Michel, Querleu Denis
Institut Claudius Regaud, Department of Surgical Oncology, Toulouse, France.
Int J Gynecol Cancer. 2009 Apr;19(3):466-70. doi: 10.1111/IGC.0b013e3181a1303e.
To describe the initial experience of laparoscopic hand-assisted Miami pouch in a group of patients undergoing pelvic exenterations for pelvic malignancies.
Thirteen female patients underwent laparoscopic-assisted pelvic exenteration in our center between September 2000 and November 2007. Six of them had the Miami pouch created for urinary diversion. The continent diversion was created extracorporeally through a right iliac fossa minilaparotomy.
The mean total operative time for the laparoscopic-assisted exenteration and reconstruction was 382 minutes (range, 270-480 minutes), but specifically for the Miami pouch, it took a mean time of 106 minutes (range, 90-130 minutes). Four patients (66.7%) had postoperative urinary tract infection that resolved with antibiotics. One patient had a ureteral stenosis requiring stenting and one had a Miami pouch cutaneous fistula that required a fistulectomy. The mean follow-up was 23 months (range, 9-48 months). All patients were continent and were able to self-catheterize approximately 3 to 6 times/d.
It is technically feasible to incorporate the creation of the Miami continent urinary pouch through a minilaparotomy during laparoscopic pelvic exenteration without compromising the benefits of laparoscopic surgery.
描述在一组因盆腔恶性肿瘤接受盆腔脏器清除术的患者中，腹腔镜辅助下迈阿密储尿囊的初步经验。
2000年9月至2007年11月期间，13名女性患者在我们中心接受了腹腔镜辅助盆腔脏器清除术。其中6例患者制作了迈阿密储尿囊用于尿液改道。通过右下腹小切口在体外构建可控性尿流改道。
腹腔镜辅助脏器清除术及重建的平均总手术时间为382分钟（范围270 - 480分钟），但专门制作迈阿密储尿囊的平均时间为106分钟（范围90 - 130分钟）。4例患者（66.7%）术后发生尿路感染，经抗生素治疗后痊愈。1例患者出现输尿管狭窄需要置入支架，1例患者出现迈阿密储尿囊皮肤瘘，需要进行瘘管切除术。平均随访时间为23个月（范围9 - 48个月）。所有患者均能自主排尿，并且能够每天自行导尿约3至6次。
在腹腔镜盆腔脏器清除术中通过小切口构建迈阿密可控性储尿囊在技术上是可行的，且不影响腹腔镜手术的优势。
