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机器人辅助交叉折叠U形体内回肠新膀胱术治疗肌层浸润性膀胱癌:初步经验及功能结果

Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes.

作者信息

Koie Takuya, Ohyama Chikara, Yoneyama Takahiro, Nagasaka Hirotaka, Yamamoto Hayato, Imai Atsushi, Hatakeyama Shingo, Hashimoto Yasuhiro

机构信息

Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

出版信息

Int J Med Robot. 2018 Dec;14(6):e1955. doi: 10.1002/rcs.1955. Epub 2018 Sep 14.

Abstract

BACKGROUND

This study compared the surgical and urinary functional outcomes in patients with muscle-invasive bladder cancer (MIBC) who underwent robot-assisted radical cystectomy (RARC) followed by intracorporeal ileal neobladder reconstruction (ICNB) to those in patients who underwent minimum incision endoscopic radical cystectomy (MIE-RC) followed by extracorporeal ileal neobladder reconstruction (ECNB).

MATERIALS AND METHODS

This study reviewed the clinical records of 153 consecutive MIBC patients who underwent neoadjuvant chemotherapy followed by radical cystectomy and ileal neobladder reconstruction.

RESULTS

The operative time in the ICNB group was significantly longer than that in the ECNB group. The median estimated blood loss was significantly less in the ICNB group than in the ECNB group. The neobladder capacity gradually increased in both groups. The maximum neobladder pressure and urethral closure pressure gradually improved in both groups.

CONCLUSION

Our initial experience with ICNB was favourable, with acceptable surgical and urinary functional outcomes.

摘要

背景

本研究比较了接受机器人辅助根治性膀胱切除术(RARC)并随后进行体内回肠新膀胱重建(ICNB)的肌层浸润性膀胱癌(MIBC)患者与接受最小切口内镜根治性膀胱切除术(MIE-RC)并随后进行体外回肠新膀胱重建(ECNB)的患者的手术和泌尿功能结果。

材料与方法

本研究回顾了153例连续接受新辅助化疗后行根治性膀胱切除术和回肠新膀胱重建的MIBC患者的临床记录。

结果

ICNB组的手术时间明显长于ECNB组。ICNB组的中位估计失血量明显少于ECNB组。两组的新膀胱容量均逐渐增加。两组的最大新膀胱压力和尿道闭合压力均逐渐改善。

结论

我们对ICNB的初步经验是良好的,手术和泌尿功能结果均可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a5/6282822/df519277a90e/RCS-14-na-g001.jpg

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