腹腔鏡膀胱摘除對於十年前接受開腹腎臟輸尿管摘除術的後期泌尿上皮癌年老病患是可行的
張殷綸1、林威宇1
嘉義長庚醫院 外科部 泌尿科1
The feasibility of laparoscopy radical cystectomy for the elder patient ( >70 y/o) with a 10 year history of advance urothelium carcinoma post open nephroureterectomy and adjuvant chemotherapy
Yin-Lun Chang1 , Wei-Yu Lin1
Divisions of Urology, Department of Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan1;
Abstract :
This 75 y/o male patient had past history of hypertension. Besides, he ever had right ureter transitional cell carcinoma(T3N2M1) status post right nephrouretrectomy and chemotherapy on 2004/07. After that he was regular follow up at our OPD.However, the recurrent bladder cancer s/p TUR-BT on 2008/6, 2010/5 and 2014/11. He also received the BCG instillation from 2010/05 to 2010/06 and Mitomycin transcather irrigation (6 times) from 2014/12 to 2015/01.Under the regular follow up cystoscopy and one papillary mass over right diverticulum was found on 2015/02. The MRU for tumor workup was arranged and bladder tumor (T2N0M0) was compatible. Then he received the radical cystoprostatectomy, left uretercutaneostomy and left iliac LN dissection by laparoscopy (transperitoneal approach) on 2015/3. There are two points for this case, including the treatment response is good for advanced stage TCC (the survival over 10 years) and laparoscopy is still feasible for patient ever received open nephroureterectomy 10 years later.