Laparoscopic En Bloc Partial Cystectomy in Urachal Adenocarcinoma: Initial Experience in Rajavithi Hospital
Tanet Thaidumrong MD*
Affiliation : * MIS Urology Rajavithi, Division of Urology, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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
