機器人手臂輔助部分膀胱切除術應用於膀胱惡性腫瘤的治療
陳鴻毅、陳文祥、林承家、黃賢祥、林政鋒、吳俊德
基隆長庚醫院 外科部 泌尿科
ROBOT-ASSISTED LAPAROSOPIC PARTIAL CYSTECTOMY FOR BLADDER MALIGNANCY
Hung-Yi Chen, Wen-Hsiang Chen, Cheng-chia Lin, Shian-Shiang Huang, Cheng-Feng Lin, Chun-Te Wu
Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelung
Purpose:
To present our experience of robot-assisted laparoscopic partial cystectomy (RALPC) as a treatment modality in patients with bladder malignancy.
Material and methods:
Between September 2010 to September 2015, four patients (mean age: 57.3 years, range 40-71) ; three isolated bladder dome mass lesions, one diverticular mass; proved as unusual bladder malignancy who received RALPC with bilateral pelvic lymphadenectomy at our hospital.
Results:
All operations were completed successfully without complication or open conversion. Mean (range) operative time was 252 (170-330) min, mean console time 137 (50-220) min, estimated blood loss was 75 (50-100) ml, duration of Foley catheterization was 14.5 (11-16) days, length of hospital stay was 6.5 (5-7) days. The pathologic entities included two urachal adenocarcinoma; one urachal urothelial carcinoma (UC); one bladder diverticular squamous cell carcinoma (SCC). Surgical margin were negative except one urachal UC with extravesicle invasion and lymph node metastasis. All patients received concurrent chemoradiotherapy (CCRT) because of beyond muscle invasive disease. No local recurrence during post-operative follow up currently. (longest follow up time: 66 months)
Conclusion:
RALPC is a feasible and safe procedure which combines the advantages of minimally invasive surgery, organ preservation and effectiveness of cancer control, which can be an alternative treatment for bladder malignancy.