【摘要】 目的 探讨腹腔镜扩大膀胱部分切除术治疗成人脐尿管肿瘤的可行性和临床疗效。方法 回顾性分析我院采用普通腹腔镜和达芬奇机器人辅助腹腔镜下扩大膀胱部分切除术治疗脐尿管肿瘤5例临床资料，手术切除范围包括脐尿管、脐孔、脐尿管肿物、脐正中韧带、部分腹膜以及与脐尿管肿物相连的部分膀胱顶部，对手术时间、术后住院天数、有无术后并发症及随访有无肿瘤复发等指标进行分析，评价手术疗效。检索国内外相关文献，讨论脐尿管肿瘤的发病特点、影像学特征以及治疗方法。结果 5例手术均成功，无中转开放，平均手术时间140 min，术中出血少，术中术后无严重并发症出现，术后平均住院天数7.4 d，其中3例行术后辅助化疗3个疗程，化疗方案为顺铂+紫杉醇，术后随访1～4年无复发。术后病理诊断1例为绒毛状腺瘤，3例为脐尿管黏液腺癌，1例为浸润性高级尿路上皮癌，所有病例切缘及淋巴结均未见癌累及。结论 腹腔镜扩大膀胱部分切除术治疗成人脐尿管肿瘤，是一种安全、有效的方法。更多还原

【Abstract】 Objective To explore the safety and clinical efficacy of laparoscopic extended partial cystectomy in the treatment of adult urachal carcinoma. Methods The clinical data of 5 cases of urachal carcinoma treated by laparoscopic and Da Vinci robot-assisted laparoscopic extended partial cystectomy were analyzed retrospectively. The operation time, postoperative hospital stay, postoperative complications and tumor recurrence were analyzed to evaluate the effect of the operation. The resected regions included urachus, umbilical foramen, urachal mass, median umbilical ligament, part of peritoneum and the top of part of bladder connected with urachal mass. The relevant literature in Chinese or English were reviewed for the characteristics of urachal tumor imaging features and treatment. Results All the 5 cases were successfully operated without conversion to open surgery, little intraoperative blood loss, no serious postoperative complications. The mean operation time was 140 minutes and the average hospital stay was 7.4 days. No recurrence after follow-up for 1 to 4 years. Among those patients, one case was villous adenoma, three cases were mucinous adenocarcinoma of urachus and one case was invasive advanced urothelial carcinoma, all of them had no involvement of carcinoma in the margins and lymph nodes.Conclusion Laparoscopic extended partial cystectomy provides a relatively safe and effective method for the treatment of urachal carcinoma in adults.更多还原