Lei Ye, Tong Shiyu, Zu Xiongbing, Li Yuan, He Wei, Hu Xiheng, Liu Wentao, Wang Zhi, Qi Lin, Chen Minfeng
Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
Urol Int. 2015;94(2):149-55. doi: 10.1159/000366067. Epub 2014 Oct 29.
This study presents our initial experience with extraperitoneal and transperitoneal laparoscopic partial cystectomy (LPC) in the treatment of benign non-urothelial bladder tumors.
Eleven patients with benign non-urothelial bladder tumors underwent extraperitoneal or transperitoneal LPC. The five cases with tumors located on the anterior/anterolateral bladder wall received the extraperitoneal approach. The six cases with tumors located around the bladder dome or over the posterior bladder wall received the transperitoneal approach. Key perioperative parameters were recorded.
All patients underwent laparoscopic resection smoothly without requiring a conversion to a traditional open procedure, and no patient displayed perioperative complications. Pathology showed benign non-urothelial bladder tumors with normal margins in all eleven patients, including five leiomyoma cases, three pheochromocytoma cases, two paraganglioma cases and one inflammatory fibrous histiocytoma case. Follow-up cystoscopy and imaging studies in all eleven patients (mean follow-up period 32 months) revealed neither residual nor local recurrence.
LPC is safe and feasible in select patients with benign non-urothelial bladder tumors and yields satisfactory oncological and functional results. Extraperitoneal LPC should be preferred for lesions located on the anterior/anterolateral bladder wall, while transperitoneal LPC should be preferred for lesions around the bladder dome or over the posterior bladder wall.
本研究介绍了我们在采用腹膜外和经腹腹腔镜部分膀胱切除术(LPC)治疗非尿路上皮性膀胱良性肿瘤方面的初步经验。
11例非尿路上皮性膀胱良性肿瘤患者接受了腹膜外或经腹LPC。5例肿瘤位于膀胱前壁/前外侧壁的患者采用腹膜外入路。6例肿瘤位于膀胱顶部周围或膀胱后壁上方的患者采用经腹入路。记录关键围手术期参数。
所有患者均顺利接受腹腔镜切除,无需转为传统开放手术,且无患者出现围手术期并发症。病理显示,11例患者均为非尿路上皮性膀胱良性肿瘤,切缘正常,其中包括5例平滑肌瘤、3例嗜铬细胞瘤、2例副神经节瘤和1例炎性纤维组织细胞瘤。11例患者(平均随访期32个月)的随访膀胱镜检查和影像学检查均未发现残留或局部复发。
LPC对于部分非尿路上皮性膀胱良性肿瘤患者是安全可行的,并且在肿瘤学和功能方面均产生令人满意的结果。对于位于膀胱前壁/前外侧壁的病变,应首选腹膜外LPC,而对于位于膀胱顶部周围或膀胱后壁上方的病变,应首选经腹LPC。