Ishiyama Yudai, Yoshida Kazuhiko, Iizuka Junpei, Unagami Kohei, Hashimoto Kiyoshi, Moriyama Ikumi, Unagami Kohei, Takagi Toshio, Kakuta Yoichi, Okumi Masayoshi, Kondo Tsunenori, Ishida Hideki, Tanabe Kazunari
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
Transplant Proc. 2020 Mar;52(2):608-613. doi: 10.1016/j.transproceed.2019.12.002. Epub 2020 Feb 19.
A higher prevalence of bladder cancer is reported in solid organ recipients, and advanced cancer requires radical cystectomy combined with urinary diversion. Surgery is technically challenging in kidney transplant recipients because of urinary tract abnormalities. Here, we describe the use of a robot-assisted approach in a kidney transplant recipient.
The etiology of the patient's end-stage renal disease was bilateral hypoplastic kidney. The patient started to receive hemodialysis at 19 years of age and underwent living-related kidney transplant at 23 years of age. Thirteen years later, he was diagnosed with invasive urothelial carcinoma and underwent robot-assisted radical cystectomy with extracorporeal neobladder construction under open laparotomy. Surgery was indicated to enhance suture flexibility and dissection of the peribladder tissues. Although the patient had an intraperitoneal infection caused by leakage from the vesicourethral anastomosis site and required drainage of the abscess, his condition stabilized after antibiotic treatment.
This case outlines the effectiveness of the robot-assisted approach in patients with urinary tract abnormalities, such as kidney transplant recipients.
实体器官移植受者中膀胱癌的患病率较高，晚期癌症需要根治性膀胱切除术并结合尿流改道。由于尿路异常，肾移植受者的手术在技术上具有挑战性。在此，我们描述了在一名肾移植受者中使用机器人辅助方法的情况。
患者终末期肾病的病因是双侧肾发育不全。患者19岁开始接受血液透析，23岁接受亲属活体肾移植。13年后，他被诊断为浸润性尿路上皮癌，并在开放剖腹手术下接受了机器人辅助根治性膀胱切除术并进行体外新膀胱构建。手术旨在提高缝合灵活性并便于膀胱周围组织的解剖。尽管患者因膀胱尿道吻合口漏引起腹腔感染且需要引流脓肿，但经抗生素治疗后病情稳定。
本病例概述了机器人辅助方法在尿路异常患者（如肾移植受者）中的有效性。
