達文西機器手臂輔助腎臟輸尿管及膀胱袖口切除術-台北榮總經驗
戴盟哲1、魏子鈞1,2、鍾孝仁1,2、林登龍1,2、陳光國1,2
台北榮民總醫院 泌尿部1；國立陽明大學醫學院 泌尿學科 書田泌尿科學研究中心2
Robot-assisted radical nephrourectomy and bladder cuff excision-
A single institute experience
Meng-Che Tai1, Tzu-Chun Wei1,2, Xial-Jen Zhong1,2, Alex T.L. Lin1,2, Kuang-Kuo Chen1,2
Department of Urology, Taipei Veterans General Hospital1
Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan2
Purpose: For patient with localized upper tract urothelial carcinoma, radical nephrourectomy and bladder cuff excision (RNU+BCE) was the standard treatment. In recent years, robot-assisted RNU and BCE (RaRNU+BCE) had been another choice of surgical intervention. This article was aimed to analyse the efficacy and peri-operative outcomes regarding RaRNU+BCE by this single institutional experience.
Materials and Methods: From March 2012 to November 2015, total 54 patients with upper tract urothelial carcinoma were treated with RaRBU+BCE at Taipei Veterans General Hospital. We collected demographic data, histopathological reports, and peri-operative complications.
Results: Total 54 patients were included in our study. The mean age was 71.9 ± 9.9 (range 48-88) and the mean body mass index was 23.5 ± 2.9 (range 16.4-30.8). Median operative time was 314 min. (RaRNU:133.9 ± 41.4 mins, RaBCE: 72.9 ± 25.7 mins). The first docking time was 26.8 ± 7.7 mins and the second docking time was 16.5 ± 6.7 mins. Median bleeding volume was 87.7 ml. Pathological stage distribution was 27.8%, 7.4%, 31.5%, 13.0%, 33.3% and 5.6% in pTa, pTis, pT1, pT2, pT3 and pT4, respectively. Complications occurred in 7 cases (13%), with 4 grade I and 3 grade II by Clavien-Dindo classification.
Conclusions: Our experience showed RaRNU+BCE is an technically feasible and safe procedure for selected patients with upper tract urothelial carcinoma.