PDF(Pubmed)
Abstract：
Bladder cancer is considered the most prevalent malignancy affecting the urinary tract system. Urothelial carcinoma, also known as transitional cell carcinoma (TCC), can arise from the entire urinary tract, with the bladder considered the primary site of origin and representing 95% of all cases. The management of TCC of the upper urinary tract is mainly by nephroureterectomy (NU). To our knowledge, there are no data regarding single-docking robotic-assisted NU following cystectomy with an ileal conduit. Therefore, in this study, we are reporting a case of single-docking robotic-assisted NU in a patient who previously underwent open cystectomy with an ileal conduit. A case of a 57-year-old female diagnosed with bladder cancer 10 years ago and underwent several transurethral resections of bladder tumor (TURBT) sessions presented for the first time in 2019, complaining of hematuria and dropping in the hemoglobin, which was not improving with multiple TURBT. For that, the patient underwent an open radical cystectomy with an ileal conduit. During the follow-up in 2021, computed tomography (CT) of the pelvis and abdomen with intravenous (IV) contrast showed a 7 mm enhancing lesion in the right proximal ureter, which was suspicious of proximal ureter mass. In 2022, the patient was again seen in the outpatient clinic; a CT of the pelvis and abdomen with IV contrast was done and demonstrated a significant progression of the mass size to 2 x 1.5 cm, with no other intraabdominal or intrathoracic lesions. For that, she underwent a single-docking robotic-assisted NU. To conclude, performing a single-docking robotic-assisted NU in a patient who previously underwent open radical cystectomy with an ileal conduit is challenging due to multiple adhesion and altered anatomy. More studies need to be published regarding the long-term outcomes of such procedures.
摘要：
膀胱癌被认为是影响泌尿系统的最常见的恶性肿瘤。尿路上皮癌,也称为移行细胞癌（TCC），可能来自整个泌尿道，膀胱被认为是主要起源部位，占所有病例的95%。上尿路TCC的治疗主要通过肾输尿管切除术（NU）进行。据我们所知,没有关于回肠导管膀胱切除术后单对接机器人辅助NU的数据.因此,在这项研究中，我们正在报告一例单对接机器人辅助NU患者,该患者先前接受了回肠导管开放性膀胱切除术.一名57岁的女性10年前被诊断患有膀胱癌，并于2019年首次进行了几次经尿道膀胱肿瘤切除术（TURBT），抱怨血尿和血红蛋白下降，这是没有改善与多个TURBT。为此，患者接受了带有回肠导管的开放性根治性膀胱切除术。在2021年的随访中，骨盆和腹部的计算机断层扫描（CT）与静脉（IV）对比显示右侧输尿管近端有7毫米的增强病变，怀疑是输尿管近端肿块。2022年，患者再次在门诊就诊;进行了骨盆和腹部的CT与IV对比，并显示肿块大小显着进展至2x1.5cm，无其他腹内或胸内病变。为此，她接受了单对接机器人辅助NU。最后，由于多次粘连和解剖结构改变,在先前接受过回肠导管开放性根治性膀胱切除术的患者中进行单对接机器人辅助NU具有挑战性.需要发表更多关于此类程序的长期结果的研究。
