Application of Xing's anastomosis technique in robot-assisted laparoscopic intracorporeal ileal conduit
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摘要: 目的探讨邢氏吻合法在机器人辅助腹腔镜下体腔内回肠通道术中的临床疗效。方法回顾分析2021年2月—2022年2月在中国医学科学院肿瘤医院行机器人辅助腹腔镜下根治性膀胱切除+体腔内回肠通道术患者的临床资料及随访数据，统计分析邢氏吻合法的临床疗效。输尿管回肠吻合方法为邢氏吻合法，即输尿管回肠端端非抗反流吻合法。结果纳入患者11例，其中男10例，女1例；平均年龄(63.0±6.3)岁，平均BMI(24±3) kg/m2。11例手术均顺利完成，无中转开放病例，无术中并发症。平均机器人操作时间(245±43) min，邢氏吻合法平均时间(26±5) min。3例(27.3%)患者发生术后并发症4项，其中轻度并发症3项，重度并发症1项，并发症均与邢氏吻合法无直接关系。病理均为尿路上皮癌，淋巴结数平均(15.8±11.0)个。中位随访时间为7个月，轻度肾积水患者1例，此患者术前有肾积水，术后3个月随访轻度肾积水；术前另外2例肾积水患者术后随访均无肾积水表现；其余患者无输尿管扩张和肾积水，无输尿管狭窄。结论邢氏吻合法在机器人辅助腹腔镜下体腔内回肠通道术中的临床疗效较好，操作简单，可重复性强，术后狭窄率低，但仍需大样本临床对照研究证实。Abstract: ObjectiveTo explore the clinical effect of Xing's anastomosis in robot-assisted laparoscopic intracorporeal ileal conduit.MethodsThe clinical and follow-up data of patients who underwent robot-assisted laparoscopic radical cystectomy and intracorporeal ileal conduit in Cancer Hospital of Chinese Academy of Medical Sciences from February 2021 to February 2022 were retrospectively analyzed, and the clinical efficacy of Xing's anastomosis was statistically analyzed. The ureter ileum anastomosis method is Xing's anastomosis, that is, the ureter ileum end-to-end non-anti-reflux anastomosis.ResultsThere were 11 patients enrolled, including 10 males and 1 female. The average age was (63.0±6.3) years old, and the average BMI was (24±3)kg/m2. All 11 operations were successfully completed without open conversion and intraoperative complications. The average robot operation time was (245±43) minutes, and the average time of Xing's anastomosis was (26±5) minutes. Four postoperative complications occurred in 3 patients(27.3%) including 3 mild complications and 1 severe complication. The complications were not directly related to Xing's anastomosis. All pathology was urothelial carcinoma, and the average number of lymph nodes was (15.8±11.0). The median follow-up time was 7 months. One patient who had hydronephrosis before surgery still had mild hydronephrosis 3 months after operation. The other 2 patients with hydronephrosis before operation had no hydronephrosis during follow-up. The remaining patients had no ureteral dilation, hydronephrosis or ureteral stenosis.ConclusionXing's anastomosis has a good clinical effect on robot-assisted laparoscopic intracorporeal ileal conduit, possessing simple procedure, good reproducibility and low stenosis rate, but it still required a large sample of clinical control study to confirm.
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Key words:
- bladder cancer /
- ileal conduit /
- robot /
- anastomosis
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