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对于一名浸润性宫颈癌放化疗后有大量残留病灶的患者,行节段性输尿管切除术,随后行输尿管膀胱吻合术,并联合根治性子宫切除术和部分膀胱切除术——病例报告

Segmentary ureteral resection followed by ureteroneocystostomy associated with radical hysterectomy and partial cystectomy in a patient with bulky residual disease after chemoirradiation for invasive cervical cancer--a case report.

作者信息

Bacalbaşa N, Bălescu I

机构信息

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

"Ponderas" Hospital, Bucharest, Romania.

出版信息

J Med Life. 2014 Oct-Dec;7(4):558-62.

Abstract

Cervical cancer represents the second most frequent malignancy in women worldwide, a significant number of cases still being diagnosed in an advanced stage of the disease. In some of these cases, local invasion is already present at the moment of diagnosis and even if neo-adjuvant chemoirradiation is performed in some patients, it persists at the moment of surgery. In these cases, more aggressive surgical procedures are needed in order to obtain a good control of the disease. The case of a 50-year-old patient diagnosed with locally advanced cervical cancer invading the right ureter is presented, in whom this aspect was present even after neo-adjuvant chemoirradiation and in whom a total radical hysterectomy with bilateral en bloc adnexectomy with partial cystectomy and the invaded zone of the right ureter was performed. The ureter was then mobilized and reimplanted in the urinary bladder through a neocystostomy. The postoperative course was uneventful.

摘要

宫颈癌是全球女性中第二常见的恶性肿瘤,仍有相当数量的病例在疾病晚期才被诊断出来。在其中一些病例中,诊断时就已经存在局部浸润,即使一些患者接受了新辅助放化疗,在手术时浸润仍持续存在。在这些情况下,需要更积极的手术操作以实现对疾病的良好控制。本文介绍了一名50岁被诊断为局部晚期宫颈癌侵犯右侧输尿管的患者,即使在新辅助放化疗后仍存在这一情况,对其实施了全子宫根治术、双侧附件整块切除术、部分膀胱切除术以及切除右侧输尿管的浸润区域。然后游离输尿管并通过新膀胱造口术将其重新植入膀胱。术后过程顺利。

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