機械手臂協助下腹腔鏡根除性膀胱切除手術及人工膀胱重建手術:單一醫學中心經驗及結果
黃詩孟1、劉建良1、黃冠華1
1奇美醫療財團法人永康奇美醫院外科部泌尿外科
Robot-assisted radical cystectomy with neobladder reconstruction:single center experience and outcome
Shih-Meng Huang1、Chien-Liang Liu1、Steven Kuan-Hua Huang1
1Division of Urology,Department of Surgery,Chi Mei Medical Center,Tainan,Taiwan
Purpose:
Robot-assisted radical cystectomy (RARC) has gained great popularity recently,but there was limited data from Taiwan on RARC. The aim of this study was to report our experience and outcomes of RARC with neobladder reconstruction in our 31 cases.
Materials and Methods:
Between January 2012 and January 2018, twenty-one male and ten female patients (median age: 64.7 years) underwent robot-assisted radical cystectomy (RARC) with extracorporeal urinary diversion(ECUD)(n=15) or intracorporeal urinary diversion(ICUD)(n=16). The neobladder was mostly formed with M-shape(n=29) and two cases were reconstructed with Detaenial sigmoid neobladder.
Results:
The median operative time and console time were 570 minutes and 380 minutes,respectively. In all patients, the median hospital stay was 18 days and the complication rate was 26%,including prolong ileus(n=5),neobladder leakage(n=2) and enterocutaneous fistula(n=1).
Conclusions:
Our experience demonstrates that RARC with ICUD or ECUD is safe and feasible with acceptable operative time and complications in centers with robotic expertise. Further studies are needed to confirm that outcomes are reproducible. RARC has led to the development of simplified techniques combined with a desire to preserve functional outcomes and prevent complications.
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