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保留膀胱的机器人盆腔清扫术治疗局部进展期直肠癌:技术与短期疗效。

Bladder preserving robotic pelvic exenteration for locally advanced rectal cancer-technique and short-term outcomes.

机构信息

Division of Colorectal Oncology, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.

Division of Urooncology, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.

出版信息

J Surg Oncol. 2022 Mar;125(3):493-497. doi: 10.1002/jso.26719. Epub 2021 Oct 18.

Abstract

AIM

In selected patients with advanced rectal cancers involving the prostate or seminal vesicles, the bladder can be preserved to avoid the complications associated with an ileal conduit. The study was aimed at reviewing the technique and short-term outcomes of patients that underwent bladder sparing robotic pelvic exenteration with suprapubic cystostomy (SPC).

METHODS

Case series of bladder preserving exenteration from a single tertiary care center. Technique for en-bloc prostatectomy with abdominoperineal resection is described.

RESULTS

Five patients underwent bladder sparing robotic pelvic exenteration with SPC, all had R0 resections. Four patients had prostatic invasion and one patient had prostatic adenocarcinoma. Postoperative complications were seen in three patients of which two were re-explored. At a median follow-up of 10 months, two patients developed systemic relapses. There were no local recurrences.

CONCLUSION

Robotic bladder sparing exenteration is technically feasible, provides acceptable short-term outcomes, and avoids complications of ileal conduit.

摘要

目的

在涉及前列腺或精囊的晚期直肠癌症的一些选定患者中,可以保留膀胱以避免与回肠导管相关的并发症。本研究旨在回顾接受耻骨上膀胱造口术(SPC)的保留膀胱机器人盆腔切除术的患者的技术和短期结果。

方法

来自单个三级护理中心的保留膀胱切除术的病例系列。描述了与经腹会阴切除术联合进行的整块前列腺切除术的技术。

结果

5 名患者接受了 SPC 的保留膀胱机器人盆腔切除术,所有患者均进行了 R0 切除。4 名患者有前列腺侵犯,1 名患者有前列腺腺癌。3 名患者出现术后并发症,其中 2 名患者进行了再次探查。在中位随访 10 个月时,2 名患者出现全身复发。没有局部复发。

结论

机器人保留膀胱的盆腔切除术在技术上是可行的,提供了可接受的短期结果,并避免了回肠导管的并发症。

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