机器人辅助原位回肠代膀胱术后膀胱阴道瘘修补术1例  

Robot-assisted repair of vesicovaginal fistula following orthotopic neobladder reconstruction:a case report

作　　者：程功 刘岳南 孙逸 赵军[1,2] 肖亚军[1,2] 陈敏[1,2] 章小平 韩晓敏 CHENG Gong;LIU Yuenan;SUN Yi;ZHAO Jun;XIAO Yajun;CHEN Min;ZHANG Xiaoping;HAN Xiaomin(Department of Urology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China;Institute of Urologic Surgery,Tongji Medical College,Huazhong University of Science and Technology)

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022 [2]华中科技大学同济医学院泌尿外科研究所

出　　处：《临床泌尿外科杂志》2024年第10期933-935,共3页Journal of Clinical Urology

摘　　要：原位回肠代膀胱术后膀胱阴道瘘的治疗是临床难题。本文报道1例女性患者因肌层浸润性膀胱癌行根治性膀胱切除+原位回肠代膀胱术,术后1年后不间断漏尿。膀胱镜显示新膀胱颈口与尿道内口交界处下方见瘘口呈横行裂口状,长约3.0 cm。遂行机器人辅助经膀胱的膀胱阴道瘘修补术,手术入路选择佳,术中瘘口平面暴露好,缝合质量高,手术顺利完成。患者术后5 d拔除尿管后带膀胱造瘘管出院,8周拔除膀胱造瘘管。术后6个月随访患者排尿正常,阴道无漏尿。The treatment of vesicovaginal fistula following orthotopic ileal neobladder surgery is a clinical challenge.This article reports a case of a female patient who underwent radical cystectomy and orthotopic ileal neobladder surgery for muscle invasive bladder cancer.One year postoperatively,she experienced continuous incontinence.Cystography revealed a fistula at the posterior edge of the base of the neobladder.Cystoscopy showed a transverse slit-like fistula at the junction below the new bladder neck and the internal urethral orifice,measuring about 3.0cm in length.Robot-assisted repair of the vesicovaginal fistula was performed,and the surgery was successful.The patient was discharged five days postoperatively after the removal of the urinary catheter,and the suprapubic catheter was removed eight weeks later.At the six-month follow-up,the patient's micturition was normal,and no leaking from vaginal.

关 键 词：膀胱阴道瘘 原位回肠代膀胱 瘘修补术 机器人辅助手术 

分 类 号：R699.7[医药卫生—泌尿科学]