Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
J Endourol. 2021 Sep;35(S2):S106-S115. doi: 10.1089/end.2020.1190.
Radical cystectomy is the standard of care for patients with nonmetastatic high-risk bladder cancer. Robotic approach to radical cystectomy has been developed to reduce perioperative morbidities and enhance postoperative recovery while maintaining oncologic control. Classically, radical cystectomy in female patient entails anterior pelvic exenteration with removal of the bladder, uterus, fallopian tubes, ovaries, anterior vaginal wall, and urethra. Pelvic organ-sparing radical cystectomy has been adopted in carefully selected patients to optimize postoperative sexual and urinary function, especially in those undergoing orthotopic urinary diversion. In this article, we describe our techniques of both classical and organ-sparing robot-assisted laparoscopic radical cystectomy in female patients. We also review patient selection criteria, perioperative management, and alternative approaches to improve operative outcomes in female patients.
根治性膀胱切除术是治疗非转移性高危膀胱癌患者的标准治疗方法。机器人辅助根治性膀胱切除术的发展旨在减少围手术期并发症，促进术后恢复，同时保持肿瘤控制。经典的女性患者根治性膀胱切除术需要进行前盆腔切除术，切除膀胱、子宫、输卵管、卵巢、前阴道壁和尿道。在精心选择的患者中采用保留盆腔器官的根治性膀胱切除术，以优化术后性功能和尿控功能，尤其是在接受原位尿流改道的患者中。本文介绍了我们在女性患者中进行经典和保留器官的机器人辅助腹腔镜根治性膀胱切除术的技术。我们还回顾了患者选择标准、围手术期管理以及改善女性患者手术结果的替代方法。
