3施設における腹腔鏡下体腔内新膀胱造設術の初期経験
(目的) 腹腔鏡下体腔内新膀胱造設術の初期経験を報告する.(対象と方法) 2019年以降に3施設で施行した8例 (男性7例, 女性1例) を対象とした. 新膀胱の術式は逆U字型とし, 6ポートで施行した. 回腸を40 cm遊離し, 脱管腔化後, 後壁縫合を行った. 膀胱尿道新吻合は体腔鏡下前立腺全摘除術と同様に両端針の連続縫合とした. 尿管吻合後, 腸管を折りたたむように前壁縫合した.(結果) 全例腹腔鏡下に完遂できた. 重篤な術後合併症は腸閉塞を1例に認め, 腹腔鏡下イレウス解除術を施行した. 排尿状態に関しては女性の1例で自己導尿を要し, 1例は全身状態悪化のため尿道カテーテル留置となった...
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| Published in | Japanese Journal of Endourology and Robotics Vol. 36; no. 2; pp. 261 - 266 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本泌尿器内視鏡・ロボティクス学会
2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 2436-875X |
| DOI | 10.11302/jserjje.36.2_261 |
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| Abstract | (目的) 腹腔鏡下体腔内新膀胱造設術の初期経験を報告する.(対象と方法) 2019年以降に3施設で施行した8例 (男性7例, 女性1例) を対象とした. 新膀胱の術式は逆U字型とし, 6ポートで施行した. 回腸を40 cm遊離し, 脱管腔化後, 後壁縫合を行った. 膀胱尿道新吻合は体腔鏡下前立腺全摘除術と同様に両端針の連続縫合とした. 尿管吻合後, 腸管を折りたたむように前壁縫合した.(結果) 全例腹腔鏡下に完遂できた. 重篤な術後合併症は腸閉塞を1例に認め, 腹腔鏡下イレウス解除術を施行した. 排尿状態に関しては女性の1例で自己導尿を要し, 1例は全身状態悪化のため尿道カテーテル留置となったが, 他の6例は自排尿可能であった.(結語) 腹腔鏡下体腔内新膀胱造設術は縫合量が多いものの, 安全に施行可能であると思われた. |
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| AbstractList | (目的) 腹腔鏡下体腔内新膀胱造設術の初期経験を報告する.(対象と方法) 2019年以降に3施設で施行した8例 (男性7例, 女性1例) を対象とした. 新膀胱の術式は逆U字型とし, 6ポートで施行した. 回腸を40 cm遊離し, 脱管腔化後, 後壁縫合を行った. 膀胱尿道新吻合は体腔鏡下前立腺全摘除術と同様に両端針の連続縫合とした. 尿管吻合後, 腸管を折りたたむように前壁縫合した.(結果) 全例腹腔鏡下に完遂できた. 重篤な術後合併症は腸閉塞を1例に認め, 腹腔鏡下イレウス解除術を施行した. 排尿状態に関しては女性の1例で自己導尿を要し, 1例は全身状態悪化のため尿道カテーテル留置となったが, 他の6例は自排尿可能であった.(結語) 腹腔鏡下体腔内新膀胱造設術は縫合量が多いものの, 安全に施行可能であると思われた. |
| Author | 小寺澤, 成紀 宗宮, 伸弥 小堀, 豪 諸井, 誠司 伊藤, 将彰 長濱, 寛二 赤尾, 利弥 東, 義人 灰谷, 崇夫 寒野, 徹 山田, 仁 |
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| References | 2) Catto JWF, Khetrapal P, Ricciardi F, et al. (2022) Effect of robot-assisted radical cystectomy with intracorporeal urinary diversion vs open radical cystectomy on 90-day morbidity and mortality among patients with bladder cancer : A randomized clinical trial. JAMA 327 (21) : 2090-2103 6) Koie T, Ohyama C, Yoneyama T, et al. (2018) Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer : Initial experience and functional outcomes. Int J Med Robot 14 (6) : e1955 1) Zhang Y, Zhou H, Tuo ZT, et al. (2022) Extraperitoneal laparoscopic radical cystectomy with intracorporeal neobladder : a comparison with transperitoneal approach. World J Surg Oncol 20 (1) : 130 10) Zhang Y, Sun C, Tuo Z, et al. (2022) Laparoscopic cystectomy with totally intracorporeal versus extracorporeal orthotopic neobladder for bladder cancer : A single center experience. J Laparoendosc Adv Surg Tech A 32 (6) : 659-667 3) Hussein AA, May PR, Jing Z, et al. (2017) Outcomes of intracorporeal urinary diversion after robot-assisted radical cystectomy : Results from the international robotic cystectomy consortium. J Urol 199 (5) : 1302-1311 5) Kanno T, Inoue T, Kawakita M, et al. (2020) Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit : A matched-pair comparison in a multicenter cohort in Japan. Int J Urol 27 (6) : 559-565 7) Koie T, Ohyama C, Makiyama K, et al. (2019) Utility of robot-assisted radical cystectomy with intracorporeal urinary diversion for muscle-invasive bladder cancer. Int J Urol 26 (3) : 334-340 8) Shao P, Li P, Ju X, et al. (2015) Laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder : technique and clinical outcomes. Urology 85 (2) : 368-373 4) Kanno T, Kobori G, Shibasaki N, et al. (2018) Laparoscopic intracorporeal ileal conduit after laparoscopic radical cystectomy : A modified technique to facilitate ureteroenteric anastomosis. Int J Urol 25 (11) : 976-978 11) Chen W, Yokoyama M, Kobayashi M, et al. (2023) Trends of radical cystectomy and comparisons of surgical outcomes among surgical approaches focusing on robot-assisted radical cystectomy : A Japanese nationwide database study. Int J Urol 30 (3) : 258-263 9) Wei H, Wang M, Wasilijiang W, et al. (2022) Propensity score-matched analysis for ileal conduit and orthotopic neobladder intracorporeally accomplished following laparoscopic radical cystectomy. Asian J Surg 45 (4) : 987-992 |
| References_xml | – reference: 4) Kanno T, Kobori G, Shibasaki N, et al. (2018) Laparoscopic intracorporeal ileal conduit after laparoscopic radical cystectomy : A modified technique to facilitate ureteroenteric anastomosis. Int J Urol 25 (11) : 976-978 – reference: 7) Koie T, Ohyama C, Makiyama K, et al. (2019) Utility of robot-assisted radical cystectomy with intracorporeal urinary diversion for muscle-invasive bladder cancer. Int J Urol 26 (3) : 334-340 – reference: 1) Zhang Y, Zhou H, Tuo ZT, et al. (2022) Extraperitoneal laparoscopic radical cystectomy with intracorporeal neobladder : a comparison with transperitoneal approach. World J Surg Oncol 20 (1) : 130 – reference: 8) Shao P, Li P, Ju X, et al. (2015) Laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder : technique and clinical outcomes. Urology 85 (2) : 368-373 – reference: 10) Zhang Y, Sun C, Tuo Z, et al. (2022) Laparoscopic cystectomy with totally intracorporeal versus extracorporeal orthotopic neobladder for bladder cancer : A single center experience. J Laparoendosc Adv Surg Tech A 32 (6) : 659-667 – reference: 6) Koie T, Ohyama C, Yoneyama T, et al. (2018) Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer : Initial experience and functional outcomes. Int J Med Robot 14 (6) : e1955 – reference: 11) Chen W, Yokoyama M, Kobayashi M, et al. (2023) Trends of radical cystectomy and comparisons of surgical outcomes among surgical approaches focusing on robot-assisted radical cystectomy : A Japanese nationwide database study. Int J Urol 30 (3) : 258-263 – reference: 2) Catto JWF, Khetrapal P, Ricciardi F, et al. (2022) Effect of robot-assisted radical cystectomy with intracorporeal urinary diversion vs open radical cystectomy on 90-day morbidity and mortality among patients with bladder cancer : A randomized clinical trial. JAMA 327 (21) : 2090-2103 – reference: 9) Wei H, Wang M, Wasilijiang W, et al. (2022) Propensity score-matched analysis for ileal conduit and orthotopic neobladder intracorporeally accomplished following laparoscopic radical cystectomy. Asian J Surg 45 (4) : 987-992 – reference: 3) Hussein AA, May PR, Jing Z, et al. (2017) Outcomes of intracorporeal urinary diversion after robot-assisted radical cystectomy : Results from the international robotic cystectomy consortium. J Urol 199 (5) : 1302-1311 – reference: 5) Kanno T, Inoue T, Kawakita M, et al. (2020) Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit : A matched-pair comparison in a multicenter cohort in Japan. Int J Urol 27 (6) : 559-565 |
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| Snippet | (目的) 腹腔鏡下体腔内新膀胱造設術の初期経験を報告する.(対象と方法) 2019年以降に3施設で施行した8例 (男性7例, 女性1例) を対象とした. 新膀胱の術式は逆U字型とし, 6ポートで施行した. 回腸を40 cm遊離し, 脱管腔化後, 後壁縫合を行った.... |
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| SubjectTerms | 体腔内新膀胱造設術 腹腔鏡下膀胱全摘除術 |
| Title | 3施設における腹腔鏡下体腔内新膀胱造設術の初期経験 |
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