PDF(Pubmed)
Abstract：
BACKGROUND: Robot-assisted nephroureterectomy for upper tract urothelial carcinoma has been increasingly performed as a minimally invasive procedure recently. However, there are concerns regarding its adoption in highly complex cases with dense adhesions.
METHODS: An 86-year-old woman presented to our hospital with gross hematuria one year after having undergone robot-assisted sacrocolpopexy using a mesh for pelvic organ prolapse. Cystoscopy revealed hematuria from the right ureteral orifice. Computed tomography suggested right hydronephrosis; retrograde pyelography showed a defect in the right renal pelvis with class V urine cytology of the urine from the right kidney. Based on these findings, a right renal pelvic tumor was diagnosed, and robot-assisted nephroureterectomy was performed. The patient was discharged on postoperative day 7 without complications.
CONCLUSIONS: To the best of our knowledge, this is the first case report in which robot-assisted radical nephroureterectomy was performed after robot-assisted sacrocolpopexy with a mesh. Dense tissue adhesions are encountered not only between the bladder and the anterior vaginal wall but also around the right ureter in the pelvis. In this case, dense adhesions were confirmed around the right ureter in the pelvis.
CONCLUSIONS: Robot-assisted nephroureterectomy may be considered an option for minimally invasive surgery in cases with a history of pelvic organ prolapse surgery using mesh.
METHODS: An 86-year-old woman presented to our hospital with gross hematuria one year after having undergone robot-assisted sacrocolpopexy using a mesh for pelvic organ prolapse. Cystoscopy revealed hematuria from the right ureteral orifice. Computed tomography suggested right hydronephrosis; retrograde pyelography showed a defect in the right renal pelvis with class V urine cytology of the urine from the right kidney. Based on these findings, a right renal pelvic tumor was diagnosed, and robot-assisted nephroureterectomy was performed. The patient was discharged on postoperative day 7 without complications.
CONCLUSIONS: To the best of our knowledge, this is the first case report in which robot-assisted radical nephroureterectomy was performed after robot-assisted sacrocolpopexy with a mesh. Dense tissue adhesions are encountered not only between the bladder and the anterior vaginal wall but also around the right ureter in the pelvis. In this case, dense adhesions were confirmed around the right ureter in the pelvis.
CONCLUSIONS: Robot-assisted nephroureterectomy may be considered an option for minimally invasive surgery in cases with a history of pelvic organ prolapse surgery using mesh.
摘要：
背景：最近，机器人辅助的上尿路尿路上皮癌肾输尿管切除术作为一种微创手术越来越多。然而,在高度复杂的粘连密集的病例中，人们担心它的采用。
方法：一名86岁的妇女在接受机器人辅助的盆腔脏器脱垂手术一年后，出现肉眼血尿。膀胱镜检查显示右侧输尿管口血尿。计算机断层扫描提示右肾积水；逆行肾盂造影显示右肾盂缺损，右肾尿液细胞学检查为V类。基于这些发现,诊断为右肾盂肿瘤,并进行了机器人辅助的肾输尿管切除术。患者于术后第7天出院，无并发症。
结论：据我们所知，这是首例病例报告,其中机器人辅助的根治性肾输尿管切除术是在机器人辅助的带网状物的骶结肠切除术后进行的.不仅在膀胱和阴道前壁之间而且在骨盆的右输尿管周围都会遇到密集的组织粘连。在这种情况下,在骨盆右侧输尿管周围证实有致密的粘连。
结论：在有盆腔器官脱垂手术史的病例中，机器人辅助肾输尿管切除术可被认为是一种微创手术选择。
方法：一名86岁的妇女在接受机器人辅助的盆腔脏器脱垂手术一年后，出现肉眼血尿。膀胱镜检查显示右侧输尿管口血尿。计算机断层扫描提示右肾积水；逆行肾盂造影显示右肾盂缺损，右肾尿液细胞学检查为V类。基于这些发现,诊断为右肾盂肿瘤,并进行了机器人辅助的肾输尿管切除术。患者于术后第7天出院，无并发症。
结论：据我们所知，这是首例病例报告,其中机器人辅助的根治性肾输尿管切除术是在机器人辅助的带网状物的骶结肠切除术后进行的.不仅在膀胱和阴道前壁之间而且在骨盆的右输尿管周围都会遇到密集的组织粘连。在这种情况下,在骨盆右侧输尿管周围证实有致密的粘连。
结论：在有盆腔器官脱垂手术史的病例中，机器人辅助肾输尿管切除术可被认为是一种微创手术选择。
