Urological oncology

Abstract

Discussion: We here demonstrated that sophisticated laparoscopic procedures like the intra-abdominal formation of an orthotopic neobladder are accomplishable with robotic assistance. Editorial CommentOver the recent years experience with laparoscopic tumor ablation in urology has been increasing. In many centers worldwide adrenalectomy, total or partial nephrectomy and radical prostatectomy are now regularly performed. Although reports on radical cystectomy do exist, this procedure has always been thought to be problematic for minimal invasive surgery due to the necessity of a subsequent reconstructive urinary diversion.In this paper by Beecken et al., the authors have managed to perform a laparoscopic radical cystectomy and an orthotopic ileal neobladder completely intracorporeally. Contrary to other reports the type of urinary diversion was similar to the urinary diversion used by open surgery. The difference lies in a different sequence of the procedure mainly for the neobladder. Although the time to perform such a procedure is respectable compared to some previous reports, it is still considerably longer than experienced surgeons would necessitate for an open procedure. Furthermore an expensive and sophisticated computerized robotic system available only in a few centers worldwide was used and most probably accounted for the success. It shows however that laparoscopic radical cystectomy and an orthotopic ileal neobladder will be improved with the development of new tools and that we are faced with the fact that in several years from now centers of excellence may perform also this procedure less invasive, and probably in a comparable time period. The increased cost of such equipment will have to be equated with reduced patients' hospitalization, morbidity and earlier return to work.

Stage-dependent increase of orosomucoid and zinc-alpha2-glycoprotein in urinary bladder cancer

“…Bladder cancer is the second most common urological cancer, and the fourth most common cancer in men and the eighth most common cancer in women in the United States [1,2]. In 60-80% of cases, bladder cancer recurs after transurethral resection while, dependent on tumor stage and grade, approximately 25% of patients with superficial tumors develop progressive disease [3,4]; 10% of all patients with superficial bladder carcinoma progress to muscle-invasive tumors [5].…”