3D腹腔镜下膀胱部分切除术治疗膀胱憩室癌1例报告并文献复习
|
摘要
目的探讨膀胱憩室癌的临床特点及3D腹腔镜下膀胱部分切除术治疗膀胱憩室癌的可行性与安全性。方法分析1例于我院接受3D腹腔镜下膀胱部分切除术治疗的膀胱憩室癌患者的临床资料,并进行文献复习。患者,男,51岁,因"无痛性肉眼血尿2个月"入院。CT增强提示膀胱左侧壁憩室并占位;尿动力学及尿流率检查提示下尿路梗阻;膀胱镜检查见膀胱颈梗阻,膀胱左侧壁近输尿管开口处见一4.0cm×3.0cm憩室,其内可见一约1.0cm×1.5cm菜花样新生物,活检提示为尿路上皮癌(T1G1)。行3D腹腔镜下膀胱部分切除+左侧输尿管膀胱再植术,患者膀胱肿瘤电切术后无复发再行二期经尿道膀胱颈切开术。结果术后病理为膀胱尿路上皮癌(T1G3),随访2年未见肿瘤复发,双肾及输尿管也未见明显扩张积水。结论影像学、膀胱镜检查及病理活检是确诊膀胱憩室癌的重要方法,3D腹腔镜下膀胱部分切除术是治疗膀胱憩室癌(≤T2期)安全而有效的方法。
Objective To observe the clinical characteristics of the bladder diverticula carcinoma and evaluate the safety and feasibility of 3 Dlaparoscopic partial cystectomy for treating carcinoma in bladder diverticulum. Methods We reported a case of 3 Dlaparoscopic partial cystectomy for treating carcinoma in bladder diverticulum and reviewed related literature.A 51-year-old male was admitted to our hospital for painless gross hematuria for 3 months.A bladder diverticular tumor were found on the left wall of bladder by CT,and urodynamic examination showed lower urinary tract obstruction.The left ureteral opening was in the diverticulum neck and a size of about 1.0 cm × 1.5 cm cauliflower-like neoplasm can be seen in a 4.0 cm × 3.0 cm diverticulum formation on the left wall of the bladder in the cystoscopic biopsy.The preliminary pathological diagnosis of urothelial cancer(T1 G1).So we choose the line of 3 Dlaparoscopic partial bladder cystectomy,left extravesical ureteral reimplantation and second transurethral resection of bladder neck. Results The postoperative pathological conclusion was urothelial cancer(T1 G3).No recurrence of the tumor was observed after 2 years of follow-up,and no significant expansion was found in both kidneys and ureters.Conclusions Imaging examination,cystoscopy and pathological examination were the main techniques in diagnosing tumor originating from the bladder diverticulum.Three dimensional laparoscopic partial cystectomy is a safe and feasibile treatment for carcinoma of bladder diverticulum(≤T2).
Objective To observe the clinical characteristics of the bladder diverticula carcinoma and evaluate the safety and feasibility of 3 Dlaparoscopic partial cystectomy for treating carcinoma in bladder diverticulum. Methods We reported a case of 3 Dlaparoscopic partial cystectomy for treating carcinoma in bladder diverticulum and reviewed related literature.A 51-year-old male was admitted to our hospital for painless gross hematuria for 3 months.A bladder diverticular tumor were found on the left wall of bladder by CT,and urodynamic examination showed lower urinary tract obstruction.The left ureteral opening was in the diverticulum neck and a size of about 1.0 cm × 1.5 cm cauliflower-like neoplasm can be seen in a 4.0 cm × 3.0 cm diverticulum formation on the left wall of the bladder in the cystoscopic biopsy.The preliminary pathological diagnosis of urothelial cancer(T1 G1).So we choose the line of 3 Dlaparoscopic partial bladder cystectomy,left extravesical ureteral reimplantation and second transurethral resection of bladder neck. Results The postoperative pathological conclusion was urothelial cancer(T1 G3).No recurrence of the tumor was observed after 2 years of follow-up,and no significant expansion was found in both kidneys and ureters.Conclusions Imaging examination,cystoscopy and pathological examination were the main techniques in diagnosing tumor originating from the bladder diverticulum.Three dimensional laparoscopic partial cystectomy is a safe and feasibile treatment for carcinoma of bladder diverticulum(≤T2).
引文
[1]孙吉,林连祥,范祎,等.腹腔镜全膀胱切除术治疗膀胱憩室癌4例报告及文献复习[J].腹腔镜外科杂志,2015,20(11):812-814.
[2] Md Noh MS,Abdul Aziz AF,Mohd Ghani KA,et al.Giant Intradiverticular Bladder Tumor[J].Am J Case Rep,2017,18:212-216.
[3]黄建华,彭波,刘敏,等.膀胱憩室癌1例报告及文献回顾[J].临床与病理杂志,2015,35(4):582-586.
[4] Elands S,Vasdev N,Tay A,et al.Robot-Assisted Laparoscopic Bladder Diverticulectomy and Ureteral Re-Implantation for a Diverticulum Containing High Grade Transitional Cell Carcinoma[J].Curr Urol,2015,8(2):104-108.
[5]王浩,陈雯,李凤陈,等.膀胱憩室癌的CT表现特征分析[J].临床放射学杂志,2017,36(3):381-383.
[6]李凤陈,戴士林,于代友,等.膀胱憩室癌1例及文献回顾[J].癌症进展,2016,14(7):709-710.
[7] Walker NF,Gan C,Olsburgh J,et al.Diagnosis and management of intradiverticular bladder tumours[J].Nat Rev Urol,2014,11(7):383-390.
[8]马春磊,徐勇,刘冉录,等.膀胱憩室癌的诊断及治疗(附15例报告)[J].山东医药,2010,50(46):37-39.
[9] Zhong H,George S,Kauffman E,et al.Clinicopathologic characterization of intradiverticular carcinoma of urinary bladder-a study of 22cases from a single cancer center[J].Diagn Pathol,2014,9:222.
[10]张青汉,陈小刚,桂定文,等.3D腹腔镜在泌尿外科手术中的应用(附6例报告)[J].临床泌尿外科杂志,2014,29(11):1010-1011.
[11] Hu B,Satkunasivam R,Schuckman A,et al.Urothelial carcinoma in bladder diverticula:outcomes after radical cystectomy[J].World J Urol,2015,33(10):1397-1402.
[12]Stimac G,Kne6evi8M,Grubi2i8I,et al.A rare case of squamous cell carcimous in urinary bladder diverticulum successfully treated by bladder-sparing surgery[J].Acta Clin Croat,2015,54(3):363-366.
[2] Md Noh MS,Abdul Aziz AF,Mohd Ghani KA,et al.Giant Intradiverticular Bladder Tumor[J].Am J Case Rep,2017,18:212-216.
[3]黄建华,彭波,刘敏,等.膀胱憩室癌1例报告及文献回顾[J].临床与病理杂志,2015,35(4):582-586.
[4] Elands S,Vasdev N,Tay A,et al.Robot-Assisted Laparoscopic Bladder Diverticulectomy and Ureteral Re-Implantation for a Diverticulum Containing High Grade Transitional Cell Carcinoma[J].Curr Urol,2015,8(2):104-108.
[5]王浩,陈雯,李凤陈,等.膀胱憩室癌的CT表现特征分析[J].临床放射学杂志,2017,36(3):381-383.
[6]李凤陈,戴士林,于代友,等.膀胱憩室癌1例及文献回顾[J].癌症进展,2016,14(7):709-710.
[7] Walker NF,Gan C,Olsburgh J,et al.Diagnosis and management of intradiverticular bladder tumours[J].Nat Rev Urol,2014,11(7):383-390.
[8]马春磊,徐勇,刘冉录,等.膀胱憩室癌的诊断及治疗(附15例报告)[J].山东医药,2010,50(46):37-39.
[9] Zhong H,George S,Kauffman E,et al.Clinicopathologic characterization of intradiverticular carcinoma of urinary bladder-a study of 22cases from a single cancer center[J].Diagn Pathol,2014,9:222.
[10]张青汉,陈小刚,桂定文,等.3D腹腔镜在泌尿外科手术中的应用(附6例报告)[J].临床泌尿外科杂志,2014,29(11):1010-1011.
[11] Hu B,Satkunasivam R,Schuckman A,et al.Urothelial carcinoma in bladder diverticula:outcomes after radical cystectomy[J].World J Urol,2015,33(10):1397-1402.
[12]Stimac G,Kne6evi8M,Grubi2i8I,et al.A rare case of squamous cell carcimous in urinary bladder diverticulum successfully treated by bladder-sparing surgery[J].Acta Clin Croat,2015,54(3):363-366.