Geehyun Song1,2, Kyung-Sik Han1, Sang Hoon Song1, Myung-Soo Choo1, Hanjong Ahn1, Bumsik Hong3. 1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea. 2. Department of Urology, Kangwon National University Hospital, Chuncheon, Korea. 3. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea. bshong@amc.seoul.kr.
Abstract
PURPOSE: The aim of this study was to report our technique of hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy and evaluate its benefits and short-term oncologic outcomes. MATERIALS AND METHODS: We included 67 consecutive patients treated by a single surgeon between June 2011 and November 2014 with hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy. We retrospectively analyzed procedure-related clinical data and short-term oncologic outcomes. RESULTS: The mean patient age was 66.2 ± 10.6 years. The mean follow-up period was 17.6 months (range 1-37 months). The mean operation time was 243.5 ± 60.4 min. There were no major accidents or open conversions. Forty-two patients (63 %) underwent immediate mitomycin C instillation without complications. There was one high-grade complication (prolonged lymphatic leakage) that required reoperation and multiple hospitalizations. Thirty patients (45 %) underwent regional lymph node dissection. The pathological stages included CIS in 2 (3 %), Ta/T1 in 32 (48 %), T2 in 6 (9 %), T3 in 27 (40 %), and N+ in 4 (6 %) cases. G1, G2, and G3 were seen in 3 (5 %), 21 (31 %), and 43 (64 %) patients, respectively. Eighteen patients (26 %) underwent postoperative adjuvant chemotherapy. Two patients died during the study period, and nine patients (13 %) had bladder recurrences. CONCLUSIONS: HAL bladder cuff excision through the same hand port used for nephroureterectomy is a feasible technique that is both amenable to oncologic principles and can reproduce the open surgical technique.
PURPOSE: The aim of this study was to report our technique of hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy and evaluate its benefits and short-term oncologic outcomes. MATERIALS AND METHODS: We included 67 consecutive patients treated by a single surgeon between June 2011 and November 2014 with hand-assisted laparoscopic bladder cuff excision through the same hand port as that used for nephroureterectomy. We retrospectively analyzed procedure-related clinical data and short-term oncologic outcomes. RESULTS: The mean patient age was 66.2 ± 10.6 years. The mean follow-up period was 17.6 months (range 1-37 months). The mean operation time was 243.5 ± 60.4 min. There were no major accidents or open conversions. Forty-two patients (63 %) underwent immediate mitomycin C instillation without complications. There was one high-grade complication (prolonged lymphatic leakage) that required reoperation and multiple hospitalizations. Thirty patients (45 %) underwent regional lymph node dissection. The pathological stages included CIS in 2 (3 %), Ta/T1 in 32 (48 %), T2 in 6 (9 %), T3 in 27 (40 %), and N+ in 4 (6 %) cases. G1, G2, and G3 were seen in 3 (5 %), 21 (31 %), and 43 (64 %) patients, respectively. Eighteen patients (26 %) underwent postoperative adjuvant chemotherapy. Two patients died during the study period, and nine patients (13 %) had bladder recurrences. CONCLUSIONS:HAL bladder cuff excision through the same hand port used for nephroureterectomy is a feasible technique that is both amenable to oncologic principles and can reproduce the open surgical technique.
Authors: Christopher B Allard; Abdulaziz Alamri; Shawn Dason; Farough Farrokhyar; Edward D Matsumoto; Anil Kapoor Journal: World J Urol Date: 2012-07-29 Impact factor: 4.226
Authors: Sandhya R Rao; Jose J Correa; Wade J Sexton; Julio M Pow-Sang; Shohreh I Dickinson; Hui-Yi Lin; Philippe E Spiess Journal: BJU Int Date: 2012-05-04 Impact factor: 5.588