J Med Assoc Thai 2018; 101 (2):164

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Laparoscopic En Bloc Partial Cystectomy in Urachal Adenocarcinoma: Initial Experience in Rajavithi Hospital
Thaidumrong T Mail

Background: Urachal carcinoma (UrC) is a rare malignancy of the bladder which is most often treated by open laparotomy partial cystectomy with or without pelvic lymph node dissection. Recently, laparoscopic surgical techniques have been developing in many countries, and a number of research papers have shared their experience of laparoscopic management of UrC.
Case Report: A 44-year-old Thai male patient presented at the Division of Urology, Rajavithi Hospital, in September 2010 having experienced gross hematuria for the previous two months. Cystoscopy and computed tomography (CT) scan of whole abdomen showed an intraluminal protruding mass centered in the bladder wall. After transurethral resection with Biopsy, pathologic results revealed adenocarcinoma of the bladder. The patient was diagnosed as having UrC and was designated a candidate for laparoscopic en bloc partial cystectomy.
Results: The operative time was 3 hours, estimated blood loss was 50 ml., there were no complications, and the Foley catheter was removed after the tenth day. Post-operative pathologic reports of UrC and free margin showed no tumor recurrence after follow-up cystoscopy every 3 months, and annual CT scan of whole abdomen for two years.
Conclusion: This single-case report describes laparoscopic en bloc partial cystectomy in a case of small urachal carcinoma; however, long-term follow-up in a larger population series is needed to finally determine the role of laparoscopy in treating this disease.

Keywords: Urachus, Urachal cancer, Urachal adrenocarcinoma, Laparoscopic partial cystectomyn


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