使用光尿管导管在结肠直肠癌高风险手术中的尿管可视化的实用性和挑战
Shunjin Ryu1, Yuta Imaizumi2, Shunsuke Nakashima2
1Department of Digestive Surgery, Kawaguchi Municipal Medical Center, 180, Nishiaraijuku, Kawaguchi City, Saitama, 333-0833, Japan. systematic.ryu1121@gmail.com.
Surgical endoscopy
|September 12, 2024
概括
在高风险结直肠癌手术中插入光尿路导管 (FUC) 防止了尿路损伤并减少了血液损失. 虽然有效,但FUC插入时间和并发症需要进一步创新,以便更轻松地进行尿路可视化.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 最少侵入性的手术
背景情况:
- 尿道损伤在0.3-1.5%的结直肠癌手术中是一种风险.
- 最少侵入性手术 (MIS) 需要尿管可视化设备以防止受伤.
- NIRCTM光尿路导管 (FUC) 有助于在MIS中进行尿路可视化.
研究的目的:
- 评估接受FUC插入结直肠癌手术的高风险患者的结果.
- 评估FUC在预防结直肠癌MIS期间尿管损伤方面的安全性和有效性.
主要方法:
- 在1月2021年至2024年5月期间,对141名为结直肠癌或复发而接受MIS的患者进行了回顾性研究.
- 由于尿管损伤的高风险和手术困难,进行了手术前的FUC插入.
- 分析了患者数据和短期结果,结果呈现为中位数和四分位数间的范围.
主要成果:
- 没有观察到尿管损伤.
- 在FUC插入过程中发生了一次尿道损伤 (0.7%).
- 平均手术时间为412分钟,平均血液损失为10毫升. 4.6%的直肠手术病例的边缘小于1毫米.
结论:
- FUC可以通过预防尿管损伤和减少血液损失来提高MIS的安全性.
- 通过允许更广泛的瘤边缘,FUC可能会提供瘤方面的优势.
- 挑战包括FUC插入时间和潜在的并发症,这表明需要改进可视化方法.
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