單手輔助式腹腔鏡切除儲精囊平滑肌惡性肉瘤
李淑文1、薛又仁1,2、黃建榮1、蕭毅君1、賴昱維1、邱文祥1
1臺北市立聯合醫院仁愛院區 外科部 泌尿科；2 國立陽明大學 醫學院 泌尿學科
Hand-assisted laparoscopic surgery for primary leiomyosarcoma of the seminal vesicle
Shu-Wen Li1, Thomas Y. Hsueh1,2, Andy. C. Huang1, Yi-Chun Hsiao1, Yu-Wei Lai1,2,
Allen W. Chiu1,2
1Division of Urology, Department of Surgery, Taipei City Hospital renai Branch, Taipei, Taiwan;
2Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Introduction: Primary leiomyosarcoma of the seminal vesicle is an extremely rare disease. There are only eight cases have been reported to date in the English literatures. Due to the rarity of the disease, data on optimal treatment are limited. Radical excision is the best chance for cure.
Herein, we report the ninth case of primary leiomyosarcoma of the seminal vesicle and the first case undergoing surgical resection by hand-assisted laparoscopic approach..
Presentation of case: A 62-year-old man presented to the urological clinic with an incidentally found pelvic tumor (9cm) on magnetic resonance imaging. Transrectal ultrasound-guided biopsy of the pelvic tumor was performed and the diagnosis of leiomyosarcoma was confirmed. The patient received hand-assisted laparoscopic tumor excision and parital cystectomy. Total operative time was 105 minutes and total blood loss was 100 ml. The patient evolved with an uneventful postoperative period, and was discharged within 8 days postoperatively. The pathologic exam showed primary leiomyosarcoma of the seminal vesicle measuring 9.5 cm.
Conclusion: Hand-assisted laparoscopic surgery provides the tactile feedback and counteract traction, thus facilitating the operative manipulations. Our report suggests that hand-assisted laparoscopic approach is a technically feasible option for patients with primary leiomyosarcoma of the seminal vesicle.