膀胱癌術(shù)后輸尿管腸吻合口狹窄的微創(chuàng)治療：機器人手術(shù)的優(yōu)勢和技術(shù)要點

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Minimally invasive treatment of ureteral-intestinal-anastomotic stenosis after bladder cancer surgery：advantages and technical points of robot-assisted surgery

QI Xiaolong

（Department of Urology，Zhejiang Provincial Peoples Hospital，Hangzhou 310000，China）

ABSTRACT：Ureteral-intestinal-anastomotic stenosis is a serious and intractable complication after radical bladder cancer resection.At present，there is no unified surgical method for the treatment of ureteral-intestinal-anastomotic stenosis，and the common ones are traditional surgical methods，endoluminal surgery and laparoscopic/robotic laparoscopic surgery.Traditional management methods are divided into open surgery and nephrostomy.At present，

endoluminal surgery is mainly suitable for patients with benign ureteral strictures and short ureteral stricture length.Studies have shown that laparoscopic ureteral reimplantation is safe and feasible for both transbladder and extravesicular surgery，and the advantages of robot-assisted surgery have become increasingly apparent.In the past 8 years，we have been using RAUR technology to treat this disease with good results，and we summarize the reasonable steps that should be followed for this surgery.In addition，ureteral reimplantations after Bricker surgery and ureteral reimplantations after orthotopic ileal neobladder surgery have their own technical points.

KEY WORDS：Da Vinci robot；laparoscopy；ureteral-intestinal-anastomotic stenosis；radical cystectomy；minimally invasive treatment；urinary diversion；robot-assisted ureteral reimplantation

摘要：輸尿管腸吻合口狹窄是膀胱癌根治尿流改道術(shù)后較為嚴重且棘手的并發(fā)癥，目前治療該并發(fā)癥

的手術(shù)方式并未統(tǒng)一，常見的有傳統(tǒng)手術(shù)、腔內(nèi)手術(shù)及腹腔鏡/機器人腹腔鏡手術(shù)等，傳統(tǒng)的手術(shù)方法分為開放手術(shù)和腎造瘺術(shù)。（剩余5736字）