Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, China.
Eur Urol. 2022 Nov;82(5):543-550. doi: 10.1016/j.eururo.2022.08.015. Epub 2022 Aug 30.
Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma. Approximately 15-20% of RMS cases arise from the bladder and prostate (B/P). The optimal treatment strategy for B/P RMS remains unclear.
To retrospectively evaluate the applicability of our procedure performed to treat paediatric patients with B/P RMS.
DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective analysis from a single tertiary referral hospital. From August 2003 to March 2021, 62 children pathologically diagnosed with B/P RMS underwent radical cystectomy and orthotopic detaenial sigmoid neobladder reconstruction in our centre.
Surgical procedures included laparoscopic radical cystectomy and detaenial sigmoid neobladder reconstruction, which is demonstrated in the accompanying video.
Demographic, clinical, and follow-up data were collected. Perioperative and long-term oncological and functional outcomes were reported. A logistic regression analysis was also performed.
All surgeries, including three intracorporeal laparoscopic surgeries, were completed successfully. Of the 62 patients, 54 were alive without evidence of disease recurrence or metastasis at the last follow-up. Five of the 14 >12-yr-old boys reported that they experienced erections. Two female patients >12 yr old reported that they menstruated. However, this was a retrospective study conducted at a single centre with limited surgeon experience.
Our results confirmed the safety and feasibility of primary orthotopic sigmoid neobladder reconstruction after radical cystectomy for paediatric patients with B/P RMS. Good outcomes in terms of oncological control and functional recovery were achieved. The high histocompatibility and tissue adaptability of children are inspiring.
We describe our stepwise technique of radical cystectomy and detaenial sigmoid neobladder reconstruction for paediatric patients with bladder and prostate rhabdomyosarcoma. With this technique, we were able to achieve good functional recovery without compromising cancer control and significantly increasing complications.
横纹肌肉瘤（RMS）是最常见的小儿软组织肉瘤。大约 15-20%的 RMS 病例发生在膀胱和前列腺（B/P）。B/P RMS 的最佳治疗策略仍不清楚。
回顾性评估我们为治疗小儿 B/P RMS 患者而采用的方法的适用性。
设计、地点和参与者：这是一项来自单一三级转诊医院的回顾性分析。2003 年 8 月至 2021 年 3 月，我们中心对 62 例经病理诊断为 B/P RMS 的儿童患者进行了根治性膀胱切除术和原位 detaenial 乙状结肠新膀胱重建。
手术包括腹腔镜根治性膀胱切除术和 detaenial 乙状结肠新膀胱重建，手术过程在随附的视频中展示。
收集了人口统计学、临床和随访数据。报告了围手术期和长期的肿瘤学和功能结果。还进行了逻辑回归分析。
所有手术，包括 3 例腹腔镜手术，均成功完成。在 62 例患者中，54 例在最后一次随访时无疾病复发或转移的证据，存活。14 名>12 岁的男孩中有 5 名报告有勃起。2 名>12 岁的女性患者报告有月经。然而，这是一项在单一中心进行的回顾性研究，外科医生经验有限。
我们的结果证实了根治性膀胱切除术后行儿童 B/P RMS 患者原位乙状结肠新膀胱重建的安全性和可行性。在肿瘤控制和功能恢复方面取得了良好的结果。儿童具有较高的组织相容性和组织适应性，令人鼓舞。
我们描述了我们对小儿膀胱和前列腺横纹肌肉瘤患者进行根治性膀胱切除术和 detaenial 乙状结肠新膀胱重建的分步技术。采用该技术，我们能够在不影响癌症控制的情况下实现良好的功能恢复，并显著降低并发症的发生率。
