Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option
| Autor: | Leszek Komasara, Piotr Czauderna, Andrzej Gołębiewski, Joanna Stefanowicz, Anna Bryks-Laszkowska |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Urinary Diversion Cystectomy Stoma 03 medical and health sciences 0302 clinical medicine Rhabdomyosarcoma medicine Humans Radical surgery Child Prostatectomy Genitourinary system business.industry Urinary Reservoirs Continent Urinary diversion Prostatic Neoplasms Vaginectomy Plastic Surgery Procedures medicine.disease Surgery Urinary Bladder Neoplasms 030220 oncology & carcinogenesis business |
| Zdroj: | International Journal of Urology. 23:679-685 |
| ISSN: | 0919-8172 |
| DOI: | 10.1111/iju.13120 |
| Popis: | Objectives To present versatile surgical reconstructive techniques and their outcomes in pediatric patients with genitourinary rhabdomyosarcoma. Methods We retrospectively analyzed the oncological and urological outcomes of seven patients treated between 1992 and 2014 according to the Cooperative Weichteilsarkom Studiengruppe protocols. Intergroup Rhabdomyosarcoma Study staging: local, six patients; and IV, one patient. Histology: embryonal, five patients; unclassified, one patient; triton tumor one patient. Surgical treatment included: cystectomy, uterectomy and partial vaginectomy, one patient; radical cystectomy, two patients; cystectomy, one patient; cystectomy with partial prostatectomy, one patient; partial cystectomy, one patient; and partial prostatectomy, one patient. Results All patients were alive in complete remission at last follow up. In four cases, ileal conduit with ureteral reimplantation with serous-lined extramural tunnel (Abol-Enein technique) was carried out, which was followed by conversion into ileal continent bladder with continent appendiceal stoma for clean intermittent catheterization in three patients. In one boy, partial cystectomy and continent reconstruction was carried out during a single surgical procedure. One child with incontinent urinary diversion is still awaiting a continence solution. One child after partial prostatectomy is continent without any voiding disturbances. Conclusions The timing and extent of radical surgery for treatment of genitourinary rhabdomyosarcoma depend on the local anatomical conditions, and the response to previous chemo- and radiotherapy. Cystectomy followed by various reconstructive techniques still remains an important option in the local treatment. |
| Databáze: | OpenAIRE |
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