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机器人辅助腹腔镜治疗先天性直肠尿道瘘伴重复尿道

Robotic-assisted laparoscopic repair of a congenital rectourethral fistula with duplicated urethra.

机构信息

Department of Urology, Vanderbilt University Medical Center, 1161 21st Ave. South, A-1302 Medical Center North, Nashville, TN 37232, USA.

Monroe Carell Jr. Children's Hospital at Vanderbilt, Division of Pediatric Urology, Nashville, TN, 37232, USA; Columbia University Irving Medical Center, Department of Urology, New York, NY 10032, USA.

出版信息

J Pediatr Urol. 2022 Jun;18(3):404-405. doi: 10.1016/j.jpurol.2022.04.013. Epub 2022 Apr 22.

Abstract

OBJECTIVE

To describe our experience with robot-assisted laparoscopic transperitoneal repair of a congenital rectourethral fistula in a pediatric patient with a urethral duplication.

METHODS

The patient is a 2-year-old male with a past medical history of Tetralogy of Fallot presenting with a febrile urinary tract infection (UTI). He was diagnosed with urethral duplication and a rectourethral fistula by voiding cystourethrogram (VCUG). The parents were counseled on various options and agreed to proceed with a robotic repair.

RESULTS

Robotic-assisted transperitoneal rectourethral fistula repair was performed. The procedure time was 229 min with an estimated blood loss (EBL) of 15 mL. His postoperative course was unremarkable. At his 2-week follow-up, the urethral catheter was removed and the patient was voiding normally and having normal bowel movements.

CONCLUSION

Congenital rectourethral fistula with urethral duplication is a rare anomaly with only a few reports in the literature. Pediatric robotic-assisted transperitoneal rectourethral fistula repair is a technically feasible approach in infants with minimal morbidity that allows for excellent visualization and avoids open repair.

摘要

目的

描述我们在一名患有尿道重复畸形的儿科患者中应用机器人辅助腹腔镜经腹腔途径治疗先天性直肠尿道瘘的经验。

方法

患者为 2 岁男性,既往有法洛四联症病史,因发热性尿路感染(UTI)就诊。他通过排尿性膀胱尿道造影(VCUG)诊断为尿道重复畸形和直肠尿道瘘。向患儿父母介绍了各种治疗方案,并建议行机器人修复。

结果

成功实施了机器人辅助经腹腔直肠尿道瘘修复术。手术时间为 229 分钟,估计失血量(EBL)为 15 毫升。他的术后过程无异常。在术后 2 周随访时,拔除了尿道导管,患者排尿正常,大便正常。

结论

先天性直肠尿道瘘伴尿道重复畸形是一种罕见的异常,文献中仅有少数报道。在婴儿中,采用儿科机器人辅助经腹腔途径治疗直肠尿道瘘具有微创性,技术上可行,能够实现良好的可视化效果,避免了开放性修复。

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