Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia
Copyright® by the International Brazilian Journal of Urology..
BACKGROUND: The ectopic pelvic kidney, a common renal anomaly, is often smaller and malformed, with a shorter and sometimes tortuous ureter (1). Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases (2), mandates radical cystectomy with a 50% 5-year survival rate (2). Despite the growing use of robot-assisted radical cystectomy (RARC) (3, 4), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported (5), in contrast to numerous open radical cystectomies (1, 6) involving an ectopic kidney.
PATIENT AND METHODS: After being diagnosed with T2 high-grade urothelial carcinoma, the 66-year-old patient, previously treated with multiple transurethral resections and adjuvant BCG therapy, received neoadjuvant chemotherapy. Preoperative staging CT revealed a 2.6 x 2.2 cm bladder neoformation and an ectopic right pelvic kidney.
RESULTS: Using the da Vinci Surgical System, radical cystectomy with ileal conduit (sec Wallace II) and lymphadenectomy were performed. During the demolition phase, the shorter right ureter was dissected with care to avoid damage to the renal pedicle. The reconstructive phase included intracorporeal urinary diversion (ICUD) and uretero-ileal anastomosis, facilitated by the favorable position of the kidney. The 8-hour console surgery resulted in minimal blood loss. Discharged on day 16 due to COVID-19, the patient exhibited positive outcomes. A 2-month CT follow-up revealed no cancer recurrence, metastasis, hydronephrosis, and complete regression of the lymphocele. Imaging follow-up continues without postoperative adjuvant chemotherapy.
CONCLUSION: Robotic surgery with intracorporeal urinary diversion holds potential for right-sided pelvic kidney cases, but additional studies are necessary for validation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
|---|---|
| Enthalten in: |
International braz j urol : official journal of the Brazilian Society of Urology - 50(2024), 2 vom: 30. März, Seite 227-228 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Puliatti, Stefano [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 22.03.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1590/S1677-5538.IBJU.2023.0608 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368767949 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368767949 | ||
| 003 | DE-627 | ||
| 005 | 20240323000847.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240229s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1590/S1677-5538.IBJU.2023.0608 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1341.xml |
| 035 | |a (DE-627)NLM368767949 | ||
| 035 | |a (NLM)38386794 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Puliatti, Stefano |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.02.2024 | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright® by the International Brazilian Journal of Urology. | ||
| 520 | |a BACKGROUND: The ectopic pelvic kidney, a common renal anomaly, is often smaller and malformed, with a shorter and sometimes tortuous ureter (1). Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases (2), mandates radical cystectomy with a 50% 5-year survival rate (2). Despite the growing use of robot-assisted radical cystectomy (RARC) (3, 4), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported (5), in contrast to numerous open radical cystectomies (1, 6) involving an ectopic kidney | ||
| 520 | |a PATIENT AND METHODS: After being diagnosed with T2 high-grade urothelial carcinoma, the 66-year-old patient, previously treated with multiple transurethral resections and adjuvant BCG therapy, received neoadjuvant chemotherapy. Preoperative staging CT revealed a 2.6 x 2.2 cm bladder neoformation and an ectopic right pelvic kidney | ||
| 520 | |a RESULTS: Using the da Vinci Surgical System, radical cystectomy with ileal conduit (sec Wallace II) and lymphadenectomy were performed. During the demolition phase, the shorter right ureter was dissected with care to avoid damage to the renal pedicle. The reconstructive phase included intracorporeal urinary diversion (ICUD) and uretero-ileal anastomosis, facilitated by the favorable position of the kidney. The 8-hour console surgery resulted in minimal blood loss. Discharged on day 16 due to COVID-19, the patient exhibited positive outcomes. A 2-month CT follow-up revealed no cancer recurrence, metastasis, hydronephrosis, and complete regression of the lymphocele. Imaging follow-up continues without postoperative adjuvant chemotherapy | ||
| 520 | |a CONCLUSION: Robotic surgery with intracorporeal urinary diversion holds potential for right-sided pelvic kidney cases, but additional studies are necessary for validation | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Video-Audio Media | |
| 700 | 1 | |a Ferretti, Stefania |e verfasserin |4 aut | |
| 700 | 1 | |a Peñaranda, Natali Rodriguez |e verfasserin |4 aut | |
| 700 | 1 | |a Eissa, Ahmed |e verfasserin |4 aut | |
| 700 | 1 | |a Ticonosco, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a De Faveri, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a De Carne, Cosimo |e verfasserin |4 aut | |
| 700 | 1 | |a Wisz, Pawel |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Tosi, Greta |e verfasserin |4 aut | |
| 700 | 1 | |a Annino, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Bianchi, Giampaolo |e verfasserin |4 aut | |
| 700 | 1 | |a Micali, Salvatore |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International braz j urol : official journal of the Brazilian Society of Urology |d 2002 |g 50(2024), 2 vom: 30. März, Seite 227-228 |w (DE-627)NLM152735291 |x 1677-6119 |7 nnns |
| 773 | 1 | 8 | |g volume:50 |g year:2024 |g number:2 |g day:30 |g month:03 |g pages:227-228 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1590/S1677-5538.IBJU.2023.0608 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 50 |j 2024 |e 2 |b 30 |c 03 |h 227-228 | ||