로봇 보조 복강경 방광적출술 및 요로전환술의 초기 경험

摘要

Purpose: Robot assisted laparoscopic radical cystectomy (RARC) is one of the options for minimal invasive treatment of muscle invasive bladder cancer or uncontrolled non muscle invasive bladder cancer. We detailed our operative techniques and initial experiences of robot assisted laparoscopic radical cystectomy with urinary diversion. Materials and Methods: From April 2010 to December 2011, 10 consecutive patients with bladder cancer who were performed robot assisted laparoscopic radical cystectomy with urinary diversion were enrolled. Patient’s demographics, intra-, perioperative data and oncologic outcome were analyzed. Urinary diversions including 9 ileal conduit and 1 ileal orthotopic neobladder were underwent extracoporeally. Results: Mean patient age was 65.1 years. The mean body mass index was 22.7kg/m². The mean operation time was 588.1min including 319.5min for robot assisted laparoscopic cystectomy (RARC), 165.0min for extracorporeal urinary diversion and 53.1min for lymph node dissection. The mean estimated blood loss was 244.7ml. The mean number of retrieved lymph node was 17.2. The pathologic report showed transitional cell carcinoma in all cases and adenocarcinoma of prostate in 2 male patients. No intra-operative complication was occurred. Conclusions: Robot assisted laparoscopic radical cystectomy could minimize surgery related complications without jeopardizing oncologic outcome. RARC may be effective treatment option for advanced bladder cancer.