腹腔镜扩大膀胱部分切除术治疗成人脐尿管肿瘤五例报告并文献复习  

Laparoscopic extended partial cystectomy for the treatment of 5 cases of adult urachal carcinoma and literature review

作　　者：刘刚 周骏[1] 梁朝朝[1] 杨诚[1] 杨发武 宋正尧[1] Liu Gang;Zhou Jun;Liang Chaozhao;Yang Cheng;Yang Fawu;Song Zhengyao(Department of Urology,the First Afiliated Hospital of Anhui Medical University,Hefei 23032,China;Department of Urology,Suixi County Hospital,Anhui 235000,China)

机构地区：[1]安徽医科大学第一附属医院泌尿外科,合肥230032 [2]濉溪县医院泌尿外科,安徽235000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2022年第5期437-441,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：安徽省泌尿外科临床医学研究中心(2019b07030004)。

摘　　要：目的探讨腹腔镜扩大膀胱部分切除术治疗成人脐尿管肿瘤的可行性和临床疗效。方法回顾性分析我院采用普通腹腔镜和达芬奇机器人辅助腹腔镜下扩大膀胱部分切除术治疗脐尿管肿瘤5例临床资料,手术切除范围包括脐尿管、脐孔、脐尿管肿物、脐正中韧带、部分腹膜以及与脐尿管肿物相连的部分膀胱顶部,对手术时间、术后住院天数、有无术后并发症及随访有无肿瘤复发等指标进行分析,评价手术疗效。检索国内外相关文献,讨论脐尿管肿瘤的发病特点、影像学特征以及治疗方法。结果5例手术均成功,无中转开放,平均手术时间140min,术中出血少,术中术后无严重并发症出现,术后平均住院天数7.4d,其中3例行术后辅助化疗3个疗程,化疗方案为顺铂+紫杉醇,术后随访1~4年无复发。术后病理诊断1例为绒毛状腺瘤,3例为脐尿管黏液腺癌,1例为浸润性高级尿路上皮癌,所有病例切缘及淋巴结均未见癌累及。结论腹腔镜扩大膀胱部分切除术治疗成人脐尿管肿瘤,是一种安全、有效的方法。Objective To explore the safety and clinical eficacy of laparoscopic extended partial cystectomy in the treatment of adult urachal carcinoma.Methods The clinical data of 5 cases of urachal carcinoma treated by laparoscopic and Da Vinci robot-assisted laparoscopic extended partial cystectomy were analyzed retrospectively.The operation time,postoperative hospital stay,postoperative complications and tumor recurrence were analyzed to evaluate the effect of the operation.The resected regions included urachus,umbilical foramen,urachal mass,median umbilical ligament,part of peritoneum and the top of part of bladder connected with urachal mass.The relevant literature in Chinese or English were reviewed for the characteristics of urachal tumor imaging features and treatment.Results All the 5 cases were successfully operated without conversion to open surgery,little intraoperative blood loss,no serious postoperative complications.The mean operation time was 140 minutes and the average hospital stay was 7.4 days.No recurrence after follow-up for 1 to 4 years.Among those patients,one case was villous adenoma,three cases were mucinous adenocarcinoma of urachus and one case was invasive advanced urothelial carcinoma,all of them had no involvement of carcinoma in the margins and lymph nodes.Conclusion Laparoscopic extended partial cystectomy provides a relatively safe and effective method for the treatment of urachal carcinoma in adults.

关 键 词：腹腔镜 脐尿管肿瘤 机器人 

分 类 号：R737.1[医药卫生—肿瘤]