OBJECTIVE: The aim of this study is to report our experience with laparoscopic radical cystectomy (LRC), evaluating the technique and perioperative and pathological outcomes. METHODS: 47 LRCs were performed due to muscle-invasive bladder cancer. Conduits were performed in 23 patients and neobladders in 23 (one bi-intestinal). One ureterocutaneostomy was created. RESULTS: In 43 patients LRC was performed with minilaparotomy for urinary diversion. The mean operation time was 290 min. Four operations were converted. Complications included sigmoid colon injury, urinary leak, lymphatic leak, short-term paralytic ileus, and heart attack. Mean blood loss was 220 ml. Hospitalization time was 6 days. Tumor stage was pT2b, pT3a, pT3b, and pT4a in 28, 13, 5, and 1 patient, respectively. No positive margins were found. The mean number of lymph nodules was 17, while in the last 25 procedures it was 21. 17% of patients had tumor in the lymph nodes. The mean follow-up was 10 months. Local recurrence and dissemination was observed in 2%. Continence in patients receiving neobladder was fully satisfactory. CONCLUSIONS: More complications are related to neobladder than to ileac conduit. LRC with minilaparotomy seems to be an attractive treatment option for patients with muscle-invasive bladder cancer. Radical cystectomy performed intracorporeally could be reserved for 'robot-assisted' operations.
OBJECTIVE: The aim of this study is to report our experience with laparoscopic radical cystectomy (LRC), evaluating the technique and perioperative and pathological outcomes. METHODS: 47 LRCs were performed due to muscle-invasive bladder cancer. Conduits were performed in 23 patients and neobladders in 23 (one bi-intestinal). One ureterocutaneostomy was created. RESULTS: In 43 patients LRC was performed with minilaparotomy for urinary diversion. The mean operation time was 290 min. Four operations were converted. Complications included sigmoid colon injury, urinary leak, lymphatic leak, short-term paralytic ileus, and heart attack. Mean blood loss was 220 ml. Hospitalization time was 6 days. Tumor stage was pT2b, pT3a, pT3b, and pT4a in 28, 13, 5, and 1 patient, respectively. No positive margins were found. The mean number of lymph nodules was 17, while in the last 25 procedures it was 21. 17% of patients had tumor in the lymph nodes. The mean follow-up was 10 months. Local recurrence and dissemination was observed in 2%. Continence in patients receiving neobladder was fully satisfactory. CONCLUSIONS: More complications are related to neobladder than to ileac conduit. LRC with minilaparotomy seems to be an attractive treatment option for patients with muscle-invasive bladder cancer. Radical cystectomy performed intracorporeally could be reserved for 'robot-assisted' operations.
Authors: J Rassweiler; K Godin; A S Goezen; D Kusche; P Chlosta; F Gaboardi; C C Abbou; R van Velthoven Journal: Urologe A Date: 2012-05 Impact factor: 0.639
Authors: Marcin Słojewski; Piotr Chłosta; Marek Myślak; Grzegorz Herlinger; Piotr Dobroński; Piotr Kryst; Tomasz Drewa Journal: Wideochir Inne Tech Maloinwazyjne Date: 2012-11-26 Impact factor: 1.195
Authors: Piotr Chlosta; Tomasz Drewa; Jerzy Siekiera; Jarosław Jaskulski; Andrzej Petrus; Krzysztof Kamecki; Witold Mikołajczak; Mateusz Obarzanowski; Andrzej Wronczewski; Krzysztof Krasnicki; Milosz Jasinski Journal: Wideochir Inne Tech Maloinwazyjne Date: 2011-09-30 Impact factor: 1.195