Inoue Yuta, Yamada Takeshi, Okusa Yuji, Taga Hideto, Ueda Takashi, Shiraishi Takumi, Fujihara Atsuko, Okumi Masayoshi, Hongo Fumiya, Ukimura Osamu
Department of Urology Kyoto Prefectural University of Medicine Kyoto Japan.
Department of Urology Kyoto Second Red Cross Hospital Kyoto Japan.
IJU Case Rep. 2024 Oct 14;8(1):28-31. doi: 10.1002/iju5.12799. eCollection 2025 Jan.
Radical cystectomy for patients who previously underwent both radical prostatectomy and prostatic bed radiation is technically challenging.
A 78-year-old man with a history of radical prostatectomy and salvage radiation for prostate cancer was referred to our hospital for radical treatment of bladder cancer. After two cycles of neoadjuvant chemotherapy, he underwent robot-assisted radical cystectomy with real-time transrectal ultrasound guidance during dissection of the rectovesical space to minimize the risk of rectal injury. There were no perioperative adverse events.
Intraoperative real-time transrectal ultrasound guidance could assist surgeons to safely perform the dissection of the rectovesical space in the surgically high-risk patient.
对于既往接受过根治性前列腺切除术和前列腺床放疗的患者，根治性膀胱切除术在技术上具有挑战性。
一名78岁男性，有前列腺癌根治性前列腺切除术和挽救性放疗史，因膀胱癌根治性治疗转诊至我院。经过两个周期的新辅助化疗后，他在直肠膀胱间隙分离过程中接受了机器人辅助根治性膀胱切除术，并采用实时经直肠超声引导，以尽量降低直肠损伤风险。围手术期未发生不良事件。
术中实时经直肠超声引导可协助外科医生在手术高风险患者中安全地进行直肠膀胱间隙分离。
