單一擺位機器人腎臟輸尿管及膀胱袖口切除術: 單一中心經驗
何肇晏1、林宜佳1,2、蔡德甫1,2、葉忠信1,2、莊光達1,2、鄭以弘1、仇光宇1,2、陳宏恩1、黃一勝1,2
1新光吳火獅紀念醫院外科部泌尿科
2輔仁大學醫學院
SINGLE-DOCKING ROBOTIC RADICAL NEPHROURETERECTOMY WITH BLADDER CUFF EXCISION IN A SINGLE INSTITUTION
Chao-Yen Ho1, Yi-Chia Lin1,2, Te-Fu Tsai1,2, Chung-Hsin Yeh1,2, Guang-Dar Juang1,2, Yi-Hong Cheng1, Kuang-Yu Chuo1,2, Hung-En Chen1, Thomas I.S. Hwang1,2
1Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital, Taipei
2School of Medicine, Fu-Jen Catholic university, New Taipei City
Purpose:
Radical nephroureterectomy with bladder cuff excision (RNU) is the standard treatment for upper tract urothelial carcinoma. Robotic platform can be utilized in this procedure. However, re-docking is required for bladder cuff excision. Herein, we report our experience on single-docking technique for robotic RNU.
Materials and Methods:
From June 2014 to February 2016, a total of 16patients who underwent robotic RNU were identified. A total of 11 patients underwent RNU without patient repositioning or robotic redocking. Demographics, perioperative parameters and post-operative details were collected and analyzed. Comparison was made between the single docking group and re-docking group.
Results:
The median operation time of the 11 patients was 280 (185-375) minutes and median blood loss is 150 (100-300) ml. No intraoperative complication was found among the single docking group. The median hospital stay was 9 days and no significant operative-related complication was noted. Pathologically, 3 patients was in Ta/T1 stage, 2 patients were in T2 stage and 5 patients were in T3/T4 stage. Recurrence over bladder was noted in 2 patients (one patient is pT2 and one is pT3). A trend of shorter operation time was noted in the single docking group (280 min vs 380 min).
Conclusions:
Single-docking robotic RNUusing our technique can be performed safely. Decreased operative time can be achieved compared to re-docking technique.