摘要
目的:介绍腹腔镜扩大性膀胱部分切除术治疗脐尿管肿瘤的改良术式,评估手术效果.方法:2009年4月～2012年12月,对12例肿瘤平均大小为3.2 cm(1.5～5.6 cm)的脐尿管癌采用改良的腹腔镜扩大性膀胱部分切除术.记录手术时间、出血量及住院时间,术后随访患者生存时间及有无肿瘤复发,评估手术效果.结果:所有病例均在腹腔镜下完成扩大性膀胱部分切除术,平均手术时间85 (65～125)min,术中评估出血量50(30～110)ml,平均住院时间6(4～7)d.无围手术期并发症发生.术后病理诊断黏液性腺癌7例,混合癌3例,乳头状腺癌2例.所有病例切缘均为阴性,淋巴结阳性5例.中位随访时间30个月,术后1年生存率为67.7％ (8/12),2年生存率为50.o％(6/12).结论:腹腔镜扩大性膀胱部分切除术治疗脐尿管癌安全可行,具有创伤小、恢复快的优点,易于推广应用.
Objective:Urachal carcinoma(UrC)is a rare malignancy,and patients with this disease have a poor prognosis.So the tumor should be removed as soon as possible.Here,we will talk about a modified laparoscopic extended partial cystectomy for the treatment of urachal carcinoma and evaluate the effect of the operations.Methods: Between April 2009and December 2012,modified laparoscopic extended partial cystectomy was performed in 12 cases in our hospital.The average tumor size was 3.2cm(1.5-5.6).The operating time,estimated blood loss and hospital stay were recorded.And the follow-up was done to evaluate the survival and recrudescence.Results:All 12 procedures were completed laparoscopically without open conversion.The median operating time was 85 minutes(65-125)with a median estimated blood loss of 50ml(30-110).The median hospital stay was 6days(4-7).The evaluations of bladder margins were negative for cancer in all cases but positive lymph nodes in 5cases.There were no intraoperative or postoperative complications.Final histopathology confirmed urachal adenocarcinoma in 7cases, mixed carcinoma in 3cases and papillary carcinoma in 2cases.At a median follow-up of 30months,the 1-year survival rates were 67.7%(8/12)and 2-year survival rates were 50.0%(6/12).Conclusions:The modified laparoscopic extended partial cystectomy and bilateral extended pelvic lymphadenectomy is a safe,feasible,minimally invasive alternative for the treatment of urachal carcinoma and is worthy to be widely applied.
出处
《微创泌尿外科杂志》
2013年第6期377-380,共4页
Journal of Minimally Invasive Urology
基金
国家高技研发计划(863计划)项目(2012AA021101)
关键词
腹腔镜
脐尿管癌
膀胱部分切除术
预后
laparoscopy
urachal carcinoma
partial cystectomy
prognosis
