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全机器人全盆腔脏器清除术。

Entirely robotic total pelvic exenteration.

作者信息

Vasilescu Catalin, Tudor Stefan, Popa Monica, Aldea Brindusa, Gluck Gabriel

机构信息

Fundeni Institute of Digestive Disease and Liver Transplantation, Bucharest, Romania.

出版信息

Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):e200-2. doi: 10.1097/SLE.0b013e3182246c17.

Abstract

OBJECTIVE

We present an entirely robotic total pelvic exenteration and extended lymphadenectomy with "barreled ureterocutaneostomy" and end colostomy for recurrent endometrial cancer. In 1948, Brunschwig first described a pelvic exenteration as treatment of advanced recurrent malignancy in the pelvis. Currently it represents the only potentially curative option for patients with recurrent endometrial cancer.

METHODS

A 69-year-old female with perineal recurrence invading urethral and vaginal walls, lower rectum and anal sphincter was the perfect candidate for total pelvic exenteration.

RESULTS

Total operative time was 250 minutes, with a console time of 175 minutes. The estimated blood loss was 365 mL.

CONCLUSIONS

Good oncological results are expected after robotic total pelvic exenteration owing to the accurate, precise dissection and the extension of lymphadenectomy in the narrow space of the deep pelvis similar to robotic prostatectomy and total mesorectal excision.

摘要

目的

我们展示了一种用于复发性子宫内膜癌的全机器人盆腔脏器清除术及扩大淋巴结清扫术,并采用“桶状输尿管皮肤造口术”和乙状结肠造口术。1948年,布伦施维格首次描述了盆腔脏器清除术作为盆腔晚期复发性恶性肿瘤的治疗方法。目前,它是复发性子宫内膜癌患者唯一可能的治愈选择。

方法

一名69岁女性,会阴复发侵犯尿道和阴道壁、低位直肠及肛门括约肌,是全盆腔脏器清除术的理想候选者。

结果

总手术时间为250分钟,控制台操作时间为175分钟。估计失血量为365毫升。

结论

由于机器人全盆腔脏器清除术能在深盆腔狭窄空间内进行精确、精准的解剖以及扩大淋巴结清扫,类似于机器人前列腺切除术和全直肠系膜切除术,因此有望获得良好的肿瘤学效果。

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