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机器人辅助膀胱切除术及体内尿流改道的当代技术与结果

Contemporary techniques and outcomes of robotic cystectomy and intracorporeal urinary diversions.

作者信息

Dason Shawn, Goh Alvin C

机构信息

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

出版信息

Curr Opin Urol. 2018 Mar;28(2):115-122. doi: 10.1097/MOU.0000000000000472.

Abstract

PURPOSE OF REVIEW

Robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is being increasingly performed worldwide. This review summarizes recent technical developments and outcome data for RARC with ICUD.

RECENT FINDINGS

With the recent description of intracorporeal continent cutaneous diversion, all classes of urinary diversion can presently be performed totally intracorporeally. The summary of our seven cases of intracorporeal continent cutaneous diversion in this article brings the number of reported cases in the literature to 17. Additional recent advancements in ICUD focus on novel technical descriptions and outcome data. Several intracorporeal orthotopic ileal neobladder techniques have been described with intermediate perioperative outcomes. There is some rationale for reduced overall, wound, gastrointestinal and genitourinary complications with ICUD.

SUMMARY

RARC with intracorporeal diversion is a feasible option for patients with bladder cancer. Prospective and randomized outcome data are needed to better characterize the benefit of ICUD in patients following radical cystectomy.

摘要

综述目的

机器人辅助根治性膀胱切除术(RARC)联合体内尿流改道(ICUD)在全球范围内的开展越来越多。本综述总结了RARC联合ICUD的近期技术进展和结果数据。

最新发现

随着近期体内可控性皮肤造口尿流改道的描述,目前所有类型的尿流改道都可以完全在体内完成。本文对我们7例体内可控性皮肤造口尿流改道病例的总结使文献中报道的病例数达到了17例。ICUD近期的其他进展集中在新的技术描述和结果数据上。已经描述了几种体内原位回肠新膀胱技术,围手术期结果处于中等水平。有理由认为ICUD可减少总体、伤口、胃肠道和泌尿生殖系统并发症。

总结

RARC联合体内尿流改道对膀胱癌患者是一种可行的选择。需要前瞻性和随机的结果数据来更好地描述ICUD在根治性膀胱切除术后患者中的益处。

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