PURPOSE: The preliminary results of laparoscopic radical cystectomy in 85 patients are presented in this study. The functional and oncologic outcomes of this procedure in these patients are discussed. PATIENTS AND METHODS: Between December 2002 and May 2006, we performed 85 laparoscopic radical cystectomies with orthotopic ileal neobladder for bladder cancer in 77 men and 8 women. A 5-port transperitoneal approach was applied. The standard bilateral pelvic lymphadenectomy was performed first, then radical cystectomy was completed laparoscopically. The construction of the ileal neobladder and the anastomosis of ureter-neobladder were performed extracorporeally. The neobladder was anastomosed to the urethral stump under laparoscopy. A nerve-sparing procedure was performed for eight patients. RESULTS: The median operative time was 320 min, and the median blood loss was 280 mL. Conversion to open surgery was not necessary in any of the patients. The average time to oral intake after operation was 3.9 days. There were no perioperative mortalities. The complication rate was 14.1% (12/85), including such complications as three uretero-pouch anastomotic strictures, one vesicourethral anastomotic stricture, one pouch-vaginal fistula, one colonic pouch fistula, one ileo-pouch fistula, three ileus, one pneumonia, and one pyelonephritis. The daytime continence rate was 91.2%, and the nighttime continence rate was 82.4% at 6 months postoperatively. The neobladder capacity was about 343 mL. Surgical margins were tumor free for all patients. Of the eight patients who underwent a nerve-sparing procedure, four patients had potency for intercourse. During a follow-up period of 1 to 41 months (average 21.3 months), three patients had local recurrence, one patient had trocar site seeding, and five patients had distant metastasis, of whom four died. CONCLUSIONS: Laparoscopic radical cystectomy with extracorporeal formation of a neobladder is a feasible procedure with low morbidity and acceptable neobladder function. Long-term follow-up is needed to confirm the oncologic outcomes.
PURPOSE: The preliminary results of laparoscopic radical cystectomy in 85 patients are presented in this study. The functional and oncologic outcomes of this procedure in these patients are discussed. PATIENTS AND METHODS: Between December 2002 and May 2006, we performed 85 laparoscopic radical cystectomies with orthotopic ileal neobladder for bladder cancer in 77 men and 8 women. A 5-port transperitoneal approach was applied. The standard bilateral pelvic lymphadenectomy was performed first, then radical cystectomy was completed laparoscopically. The construction of the ileal neobladder and the anastomosis of ureter-neobladder were performed extracorporeally. The neobladder was anastomosed to the urethral stump under laparoscopy. A nerve-sparing procedure was performed for eight patients. RESULTS: The median operative time was 320 min, and the median blood loss was 280 mL. Conversion to open surgery was not necessary in any of the patients. The average time to oral intake after operation was 3.9 days. There were no perioperative mortalities. The complication rate was 14.1% (12/85), including such complications as three uretero-pouch anastomotic strictures, one vesicourethral anastomotic stricture, one pouch-vaginal fistula, one colonic pouch fistula, one ileo-pouch fistula, three ileus, one pneumonia, and one pyelonephritis. The daytime continence rate was 91.2%, and the nighttime continence rate was 82.4% at 6 months postoperatively. The neobladder capacity was about 343 mL. Surgical margins were tumor free for all patients. Of the eight patients who underwent a nerve-sparing procedure, four patients had potency for intercourse. During a follow-up period of 1 to 41 months (average 21.3 months), three patients had local recurrence, one patient had trocar site seeding, and five patients had distant metastasis, of whom four died. CONCLUSIONS: Laparoscopic radical cystectomy with extracorporeal formation of a neobladder is a feasible procedure with low morbidity and acceptable neobladder function. Long-term follow-up is needed to confirm the oncologic outcomes.
Authors: Simone Albisinni; Ksenija Limani; Lisa Ingels; Felix Kwizera; Renaud Bollens; Eric Hawaux; Thierry Quackels; Marc Vanden Bossche; Alexandre Peltier; Thierry Roumeguère; Roland van Velthoven Journal: World J Urol Date: 2014-01-28 Impact factor: 4.226
Authors: Morgan Rouprêt; Gordon Smyth; Jacques Irani; Laurent Guy; Jean-Louis Davin; Fabien Saint; Christian Pfister; Hervé Wallerand; François Rozet Journal: World J Urol Date: 2008-11-20 Impact factor: 4.226
Authors: Bhavan Prasad Rai; Jasper Bondad; Nikhil Vasdev; Jim Adshead; Tim Lane; Kamran Ahmed; Mohammed S Khan; Prokar Dasgupta; Khurshid Guru; Piotr L Chlosta; Omar M Aboumarzouk Journal: Cochrane Database Syst Rev Date: 2019-04-24
Authors: T Lin; X Fan; C Zhang; K Xu; H Liu; J Zhang; C Jiang; H Huang; J Han; Y Yao; W Xie; W Dong; L Bi; J Huang Journal: Br J Cancer Date: 2014-01-09 Impact factor: 7.640
Authors: Antonio Luigi Pastore; Giovanni Palleschi; Luigi Silvestri; Giuseppe Cavallaro; Mario Rizzello; Gianfranco Silecchia; Cosimo de Nunzio; Samer Fathi Al-Rawashdah; Vincenzo Petrozza; Antonio Carbone Journal: BMC Urol Date: 2014-11-18 Impact factor: 2.264
Authors: Young Dong Yu; Jin Ho Hwang; Young Eun Seo; Byung Do Song; Yeon Soo Jung; Dong Hwan Lee; Sung Kyu Hong; Seok-Soo Byun; Sang Eun Lee; Jong Jin Oh Journal: Sci Rep Date: 2018-03-15 Impact factor: 4.379