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女性患者机器人辅助根治性膀胱切除并体内新膀胱构建术后含吻合钉输尿管结石形成:一例罕见并发症的病例报告

Staple Containing Ureteral Stone Formation After Robot-Assisted Radical Cystectomy With Intracorporeal Neobladder Construction in a Female Patient: A Case Report of a Rare Complication.

作者信息

Liakos Nikolaos, Mendrek Mikolaj A, Karagiotis Theodoros, Leyh-Bannurah Sami-Ramzi, Witt Joern

机构信息

Department of Urology, Pediatric Urology and Urological Oncology, St. Antonius Hospital Gronau, Gronau, DEU.

出版信息

Cureus. 2022 Aug 5;14(8):e27712. doi: 10.7759/cureus.27712. eCollection 2022 Aug.

Abstract

Radical cystectomy with intracorporeal neobladder formation is a well-established treatment for patients with muscle-invasive urothelial cancer of the bladder. After the wide implementation of robotic systems, numerous centers increasingly offer intracorporeal neobladder construction using robotic staple devices. Stone formation at the area of staple material migration is a long-term complication, as staple material may migrate through the neobladder wall and act as a nidus for urine crystal aggregation. Stone formation in the upper urinary tract and the diversion segment is highly variable and corresponding management protocols are extensively reported in the previous series. However, the presence of staple material within a renal or ureteral stone has been rarely reported before. We present a case of a female patient with a staple-containing ureteral stone four years after radical cystectomy and neobladder formation and the consequent antegrade ureterorenoscopic retrieval. This treatment option is feasible, safe and easily implemented by experienced endourologists.

摘要

根治性膀胱切除术联合体内新膀胱成形术是治疗肌层浸润性膀胱尿路上皮癌患者的一种成熟疗法。随着机器人系统的广泛应用,众多中心越来越多地采用机器人吻合器械进行体内新膀胱构建。吻合材料迁移部位的结石形成是一种长期并发症,因为吻合材料可能会穿过新膀胱壁,成为尿结晶聚集的核心。上尿路和改道部位的结石形成差异很大,之前的系列报道中已广泛提及相应的处理方案。然而,肾或输尿管结石内存在吻合材料此前鲜有报道。我们报告一例女性患者,在根治性膀胱切除术和新膀胱成形术后四年出现含吻合材料的输尿管结石,并随后通过顺行输尿管肾镜取出。这种治疗选择可行、安全,且经验丰富的泌尿外科内镜医师易于实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b519/9441187/fa268362a5fb/cureus-0014-00000027712-i01.jpg

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