Department of Urology and Urologic Oncology, City of Hope, Duarte, CA 91010, USA.
Int J Med Robot. 2010 Sep;6(3):315-23. doi: 10.1002/rcs.335.
We report our technique for robotic-assisted laparoscopic radical cystoprostatectomy (RARCP) and extracorporeal urinary diversion and present their clinical outcomes.
Between October 2003 and December 2008 we performed 58 RARCPs with extracorporeal continent urinary diversion. Preoperative, operative and postoperative data was evaluated.
Mean patient age was 68 (range 46-89) years, with an average American Society of Anesthesiologists classification of 2.9. Mean operative time was 8 (range 5-11) h. Median blood loss was 450 ml. Thirteen patients received intra-operative blood transfusions and 22 patients received peri-operative blood transfusions. Continent urinary diversions were performed by means of the Studer technique (n = 42) or Indiana pouch (n = 16). Mean number of lymph nodes examined on lymphadenectomy was 27 (range 0-52).
Our RARCP and continent diversion technique is a safe and feasible option for primary urothelial carcinoma of the bladder. Oncological and surgical outcomes are comparable to open cystectomy series.
我们报告了机器人辅助腹腔镜根治性膀胱前列腺切除术（RARCP）和体外尿流改道的技术，并介绍了其临床结果。
我们在 2003 年 10 月至 2008 年 12 月期间对 58 例接受体外可控性尿流改道的患者进行了 RARCP。评估了术前、术中和术后的数据。
患者的平均年龄为 68 岁（范围 46-89 岁），平均美国麻醉医师协会分级为 2.9 级。平均手术时间为 8 小时（范围 5-11 小时）。中位失血量为 450 毫升。13 名患者术中输血，22 名患者围手术期输血。采用 Studer 技术（n=42）或 Indiana 袋（n=16）进行可控性尿流改道。淋巴结清扫术时检查的平均淋巴结数为 27 个（范围 0-52 个）。
我们的 RARCP 和可控性尿流改道术是治疗原发性膀胱尿路上皮癌的一种安全可行的选择。肿瘤学和手术结果与开放性膀胱切除术系列相当。
