在根治性膀胱切除术和新膀胱重建术后，使用纤维蛋白胶成功闭合顽固性新膀胱-尿道吻合口漏。
Successful wound closure using fibrin glue for intractable neobladder-urethral anastomosis leakage after radical cystectomy and neobladder reconstruction.
作者信息
Ishikawa Keisuke, Nagata Masayoshi, Anno Yuta, Yamagishi Miki, China Toshiyuki, Shimizu Fumitaka, Isotani Shuji, Muto Satoru, Horie Shigeo
机构信息
Department of Urology Juntendo University Graduate School of Medicine Tokyo Japan.
出版信息
IJU Case Rep. 2023 Jul 10;6(5):267-270. doi: 10.1002/iju5.12592. eCollection 2023 Sep.
INTRODUCTION
Complications of cystectomy and neobladder reconstruction such as anastomotic leakage have been reported. It is a common complication; however, most cases improve conservatively. The use of fibrin glue for fistulas has been reported, but no reports have shown its effectiveness for urinary tract anastomotic leakage. We experienced a case of intractable neobladder-urethral anastomosis leakage after radical cystectomy and neobladder reconstruction, which was effectively managed using fibrin glue.
CASE PRESENTATION
A 70-year-old man underwent radical cystectomy and ileal neobladder reconstruction for invasive bladder cancer with urothelial carcinoma. After surgery, the urethral catheter fell off and the anastomotic leakage did not improve by adjusting the position of the urethral catheter and percutaneous nephrostomy. We closed the intractable neobladder-urethral anastomotic leakage by injecting fibrin glue and the leakage completely disappeared.
CONCLUSION
Injecting fibrin glue into anastomotic site can be effective in severe neobladder-urethral anastomosis leakage.
引言
膀胱切除术和新膀胱重建的并发症，如吻合口漏已有报道。这是一种常见的并发症；然而，大多数病例通过保守治疗可好转。已有关于使用纤维蛋白胶治疗瘘管的报道，但尚无报告显示其对尿路吻合口漏有效。我们遇到一例根治性膀胱切除术后新膀胱尿道吻合口顽固性漏的病例，使用纤维蛋白胶有效处理了该问题。
病例介绍
一名70岁男性因浸润性膀胱尿路上皮癌接受了根治性膀胱切除术和回肠新膀胱重建术。术后，尿道导管脱落，通过调整尿道导管位置和经皮肾造瘘术，吻合口漏仍未改善。我们通过注射纤维蛋白胶封闭了顽固性新膀胱尿道吻合口漏，漏液完全消失。
结论
在吻合部位注射纤维蛋白胶对严重的新膀胱尿道吻合口漏可能有效。
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