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在接受持续性非卧床腹膜透析的前列腺癌患者中进行机器人辅助腹腔镜前列腺切除术。

Robot-Assisted Laparoscopic Prostatectomy in a Prostate Cancer Patient Undergoing Continuous Ambulatory Peritoneal Dialysis.

作者信息

Kuribayashi Sohei, Takezawa Kentaro, Okuda Yohei, Kawamura Masataka, Kishimoto Nozomu, Tanigawa Go, Tsutahara Koichi, Takao Tetsuya, Yamaguchi Seiji

机构信息

Department of Urology, Osaka General Medical Center, Osaka, Japan.

出版信息

J Endourol Case Rep. 2017 Apr 1;3(1):42-44. doi: 10.1089/cren.2017.0014. eCollection 2017.

Abstract

Robot-assisted laparoscopic prostatectomy (RALP) has become the gold standard treatment for organ-confined prostate cancer. However, no proper surgical approach or appropriate postsurgical management of RALP has been established for a patient undergoing peritoneal dialysis. Here, we present a case of a peritoneal dialysis patient who underwent RALP and reinstated peritoneal dialysis with no trouble associated with peritoneal dialysis. The patient was a 61-year-old man with organ-confined prostate cancer. He had been on peritoneal dialysis for 2 years. The peritoneal dialysis catheter was routed subcutaneously from the left lateral region into the abdominal cavity at the paramedian region. RALP was performed by the transperitoneal anterior approach. The surgical maneuver was not influenced by the peritoneal dialysis catheter at all. At the end of surgery, the incised peritoneum was sutured and closed tightly. After surgery, peritoneal dialysis was temporarily interrupted for 2 weeks. Then it was safely reinitiated with no complications. Transperitoneal RALP with complete peritoneal repair can be a standard treatment option for a prostate cancer patient undergoing peritoneal dialysis.

摘要

机器人辅助腹腔镜前列腺切除术(RALP)已成为局限性前列腺癌的金标准治疗方法。然而,对于接受腹膜透析的患者,尚未确立合适的RALP手术入路或术后适当的管理方法。在此,我们报告一例接受RALP手术并恢复腹膜透析且未出现与腹膜透析相关问题的腹膜透析患者。该患者为一名61岁男性,患有局限性前列腺癌。他已接受腹膜透析2年。腹膜透析导管经皮下从左侧区域引入腹腔正中旁区域。RALP通过经腹腔前路进行。手术操作完全不受腹膜透析导管的影响。手术结束时,将切开的腹膜缝合并紧密关闭。术后,腹膜透析暂时中断2周。然后安全地重新开始,未出现并发症。对于接受腹膜透析的前列腺癌患者,经腹腔RALP联合完全腹膜修复可以作为一种标准的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f7/5397213/84ee7ef99cc1/fig-1.jpg

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