Stopiglia Rafael Mamprin, Ferreira Ubirajara, Faundes Daniel Gustavo, Petta Carlos Alberto
Grupo de Urologia Oncológica, Universidade de Campinas, UNICAMP, SP, Brasil.
Centro de Reprodução Humana Campinas, SP, Brasil.
Int Braz J Urol. 2017 Jan-Feb;43(1):87-94. doi: 10.1590/S1677-5538.IBJU.2014.0362.
Endometriosis is a disease with causes still unclear, affecting approximately 15% of women of reproductive age, and in 1%-2% of whom it may involve the urinary tract. The bladder is the organ most frequently affected by endometriosis, observed around 85% of the cases. In such cases, the most effective treatment is partial cystectomy, especially via videolaparoscopy. Study Objective, Design, Size and Duration: In order to identify and delimit the extent of the intravesical endometriosis lesion, to determine the resection limits, as well as to perform an optimal reconstruction of the organ aiming for its maximum preservation, we performed a cystoscopy simultaneously with the surgery, employing a modified light-tolight technique in 25 consecutive patients, from September 2006 to May 2012.
Study performed at Campinas Medical Center - Campinas - Sao Paulo - Brazil. Participants/materials, setting and methods: Patients aged 27 to 47 (average age: 33.4 years) with deep endometriosis with total bladder involvement were selected for the study. The technique used was conventional laparoscopy with a transvaginal uterine manipulator and simultaneous cystoscopy (the light-to-light technique). A partial videolaparoscopic cystectomy was performed with cystoscopy-assisted vesical reconstruction throughout the entire surgical time. The lesions had an average size of 2.75cm (ranging from 1.5 to 5.5cm). The average surgical time was 137.7 minutes, ranging from 110 to 180 minutes.
Postoperative follow-up time was 32.4 months (12-78 months), with clinical evaluation and a control cystoscopy performed every six months. No relapse was observed during the follow-up period.
A cystoscopy-assisted partial laparoscopic cystectomy with a modified light-to-light technique is a method that provides adequate identification of the lesion limits, intra or extravesically. It also allows a safe reconstruction of the organ aiming for its maximum preservation.
子宫内膜异位症是一种病因仍不明确的疾病，影响约15%的育龄女性，其中1%-2%可能累及泌尿道。膀胱是受子宫内膜异位症影响最频繁的器官，约85%的病例可见。在这种情况下，最有效的治疗方法是部分膀胱切除术，尤其是通过视频腹腔镜手术。研究目的、设计、规模和持续时间：为了识别和界定膀胱内子宫内膜异位症病变的范围，确定切除界限，并为最大程度保留器官进行最佳的器官重建，我们在2006年9月至2012年5月期间，对25例连续患者采用改良的光对光技术，在手术同时进行膀胱镜检查。
研究在巴西圣保罗坎皮纳斯坎皮纳斯医学中心进行。参与者/材料、地点和方法：选择年龄在27至47岁（平均年龄：33.4岁）、患有累及整个膀胱的深部子宫内膜异位症的患者进行研究。使用的技术是传统腹腔镜检查结合经阴道子宫操纵器和同步膀胱镜检查（光对光技术）。在整个手术过程中，进行视频腹腔镜辅助部分膀胱切除术并进行膀胱镜辅助膀胱重建。病变平均大小为2.75厘米（范围为1.5至5.5厘米）。平均手术时间为137.7分钟，范围为110至180分钟。
术后随访时间为32.4个月（12 - 78个月），每六个月进行临床评估和对照膀胱镜检查。随访期间未观察到复发。
采用改良光对光技术的膀胱镜辅助部分腹腔镜膀胱切除术是一种能够充分识别膀胱内或膀胱外病变界限的方法。它还能为最大程度保留器官进行安全的重建。
