Total Laparoscopic Nephroureterectomy and Bladder Cuff Excision for a Renal Pelvic Tumor in an Atrophic Kidney: Case Report and Technical Considerations

以全腹腔鏡腎臓輸尿管及膀胱袖切除來治療萎縮腎臓的腎盂腫瘤：病例報告及技術面考量

廖建華(Alex C. Liao) ； 林嘉祥(Victor C. Lin) ； 鄭哲舟(Tse-Chou Cheng) ； 邱文祥(Allen W. Chiu) ； 李瀛輝(Ying-Huei Lee)

《臺灣泌尿科醫學會雜誌》 16卷1期 (2005/03) Pp. 25-30

摘要

一位57歲女性因間斷性血尿持續數週而至本院求診。術前檢查包括靜脈注射腎盂造影、逆行性腎盂造影及腹部電腦斷層攝影，高度懷疑於左側萎縮腎臓之腎盂中有移行細胞癌之可能。手術以全腹腔鏡進行腎臓輸尿管及膀胱袖切除，並在體內利用徒手縫合方式修補膀胱缺損處。手術完成後，標本先裝載在內視鏡標本收集袋，並利用-3.5公分之下腹部橫向傷口取出術後病人恢復情況良好。我們的經驗是在適合的病人，施以全腹腔鏡腎臓輸尿管及膀胱袖切除是有效率及可行的，而且可以在遵守腫瘤治療原則之下達到最小之侵襲性。

關鍵字

腹腔鏡 ； 腎臓輸尿管切除 ； 上泌尿道移行細胞癌

並列摘要

A 57-year-old female presented with intermittent painless gross hematuria for several weeks. In the preoperative evaluations, including intravenous urography, retrograde pyelography, and computed tomography, transitional cell carcinoma of the renal pelvis of the left atrophy kidney was highly suspected. After a transperitoneal laparoscopic left nephroureterectomy, the bladder cuff was excised and intracorporeally repaired, exclusively using the free-hand suture-and-knotting technique. The specimen was retrieved via an Endo Pocket(superscript ®) (Unimax Medical Systems, Taiwan) through a 3.5-cm Pfannestiel incision. Her postoperative recovery was prompt and excellent. Therefore, a total laparoscopic nephroureterectomy with bladder cuff excision, in selected cases completely carried out intracorporeally while adhering to all oncological principles, is efficacious and safe, with minimal invasiveness.

並列關鍵字

laparoscope ； nephroureterectomy ； upper tract transitional cell carcinoma