Sánchez de Badajoz E, Gallego Perales J L, Reche Rosado A, Gutierrez de la Cruz J M, Jimenez Garrido A
Department of Surgery, University of Málaga Faculty of Medicine, Spain.
J Endourol. 1995 Feb;9(1):59-62. doi: 10.1089/end.1995.9.59.
A completely new combined laparoscopic cystectomy and ileal conduit technique for removal of an infiltrating bladder cancer was carried out on a 64-year-old woman. The bladder was dissected free and extracted whole through the right flank. The right ureter and a loop of intestine were withdrawn through the same incision. An ileal segment was isolated and intestinal continuity restored. The right ureter was anastomosed to one extreme of the segment that was then reintroduced into the abdomen, taken across to the left side, withdrawn with the left ureter, anastomosed extracorporeally, and reintroduced. The stoma was constructed in the left flank at the patient's request. Recuperation was unusually fast and painless, and little postoperative analgesia was required. Further experience and a two-team approach could reduce the operation time to 3 or 4 hours. We are now convinced that combining the two procedures was better for the patient, even though it prolonged the time in the operating room.
对一名64岁女性实施了一种全新的联合腹腔镜膀胱切除术和回肠代膀胱术，用于切除浸润性膀胱癌。游离膀胱并通过右腹外侧将其完整取出。右输尿管和一段肠管通过同一切口引出。分离一段回肠并恢复肠道连续性。将右输尿管吻合至该段肠管的一端，然后将该段肠管重新引入腹腔，拉至左侧，与左输尿管一起引出，在体外进行吻合，再重新引入。应患者要求在左腹外侧造口。恢复异常迅速且无痛，术后几乎无需镇痛。进一步的经验和两组协作的方式可将手术时间缩短至3或4小时。我们现在确信，尽管这延长了手术室中的时间，但将这两种手术结合对患者更好。
