Laparoscopic Radical Cystectomy: a 5-year review of a single institute's operative data and complications and a systematic review of the literature

Aboumarzouk, Omar; Drewa, Tomasz; Olejniczak, Paweł; Chłosta, Piotr

doi:10.1590/s1677-55382012000300006

Cited by 35 publications

(30 citation statements)

References 19 publications

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“…Although the EAU guidelines on urolithiasis recommend PCNL or ESWL as the first-line treatment for renal stones ≥15 mm, FURS is preferable in selected cases [3,13,14,15,16,17]. …”

Section: Discussionmentioning

confidence: 99%

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

Xu¹,

Song

Jiang³

et al. 2014

Urol Int

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Objective: To evaluate the efficiency and safety of flexible ureteroscopy (FURS) and holmium lithotripsy for intrarenal stones and to stratify the efficiency and safety by stone burdens of ≤20, 20-40, and ≥40 mm. Methods: Five hundred eighty-two patients with intrarenal stones were treated with FURS and holmium lithotripsy at a single department from August 2008 to October 2013. Stone size was evaluated by calculating the cumulative stone diameter of all intrarenal stones, and stone-free status was defined as the absence of any stone or stone fragment <1 mm in the kidney. Results: Data analysis revealed a mean stone burden of 21.8 ± 7.6 mm. The overall primary stone-free rate (SFR) was 65.3%, which increased to 89.0% 6 months after the first surgery. Complications developed in 6.7% of patients. A significant difference was found between lower-calyx stones and other stones (p < 0.001; p = 0.006), while noncalcium stones had a much higher SFR than calcium stones (p < 0.001; p = 0.04). Conclusion: Our study showed that the overall renal SFR with the use of FURS and holmium lithotripsy was satisfactory, with a relatively low complication rate. We believe that FURS with holmium lithotripsy could be a valuable choice for patients with renal stones, especially for patients with a cumulative stone burden ≤40 mm.

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“…Although the EAU guidelines on urolithiasis recommend PCNL or ESWL as the first-line treatment for renal stones ≥15 mm, FURS is preferable in selected cases [3,13,14,15,16,17]. …”

Section: Discussionmentioning

confidence: 99%

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

Xu¹,

Song

Jiang³

et al. 2014

Urol Int

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“…Nonetheless, numerous studies have demonstrated increased skills with LRC to be able to consider it as a replacement for open surgery, or at least adding it to their armament of procedures [6,7,8,9,10,11,15,16,17,18]. …”

Section: Discussionmentioning

confidence: 99%

“…With improved equipment and increasing skills in laparoscopic surgery, laparoscopic radical cystectomy (LRC) has been adopted in numerous centers worldwide [3,5,6]. Although LRC has not evolved and been adopted as quickly as laparoscopic prostatectomy or nephrectomy, reports with favorable results have emerged [3,4,6].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic versus Open Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Single Institute Comparative Analysis

Aboumarzouk

Drewa

Olejniczak³

et al. 2013

Urol Int

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Background: Open radical cystectomy (ORC) is the gold standard of treatment for muscle-invasive bladder cancer. Laparoscopic radical cystectomy (LRC) has emerged to provide an alternative. Methods: Between 2006 and 2012, 155 patients who underwent LRC or ORC were compared (mean follow-up 53 months). Results: The ORC group had shorter operative times (p < 0.0001), more blood loss (p < 0.00001), more transfusion requirement (p < 0.00001), longer postoperative length of hospital stay (p < 0.00001) and more morphine requirement (p = 0.02). No difference was found regarding lymph node yield (p = 0.07), positive margins (p = 0.11), cystectomy pathology results (p > 0.05) and positive lymph nodes (p = 0.02). The ORC group had less intraoperative complications (p = 0.03). No difference was found between the two groups regarding 5-year overall survival (p = 0.93), cancer-specific survival (p = 0.7) and recurrence-free survival (p = 0.62). Conclusion: LRC can be considered as an alternative to ORC with good operative and postoperative results in addition to comparable 5-year survival results.

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“…In a review of the literature of the studies reporting on 50 or more LRC procedures, we found that neobladder formation was 2.5 times more prevalent than conduit formation (130 conduits: 315 neobladders) [11]. Furthermore, numerous studies, including a Cochrane review, have reported on the comparison of conduits and neobladders, with no definite unanimous superiority of one over the other [12–19].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical cystectomy: neobladder or ileal conduit, debate still goes on

Aboumarzouk

Drewa

Olejniczak³

et al. 2014

CEJU

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ObjectiveTo compare the pre, intra, and post–operative data between ileal conduit and neobladder urinary diversions during laparoscopic radical cystectomy(LRC).Material and methodsBetween 2006 and 2011, 63 patients who underwent LRC and urinary diversion had their data input prospectively into a database and said data used for the analysis. The outcome comparators were the patient demographics, operative time, conversion rate, blood loss, transfusion rate, morphine analgesic requirement, length of hospital stay, complication rates, follow up, and quality of life assessments. A Mantel–Haenszel test was used for dichotomous data and an inverse variance method was used for continuous data. P values less than 0.5 were considered significantResultsThirty–nine patients (60 ±7.11 years) had ileal conduits and 24 patients (57 ±8.68 years) had neobladder urinary diversion. No difference was found (P >0.05) regarding age, BMI, smoking history, TURBT pathology result, blood loss, blood transfusion requirement, conversion rates, length of hospital stay, morphine requirement, complications, or follow–up and quality of life. The neobladder groups did have more previous abdominal operations and had significantly longer operative time.ConclusionsWe found no difference between either types of diversion in all comparative aspects except that the neobladder had longer operative times. This is the first comparative study between ileal conduit and neobladder urinary diversion after laparoscopic radical cystectomy and can pose as a bench mark for future comparisons.

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Laparoscopic Radical Cystectomy: a 5-year review of a single institute's operative data and complications and a systematic review of the literature

Cited by 35 publications

References 19 publications

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

Flexible Ureteroscopy with Holmium Laser Lithotripsy: A New Choice for Intrarenal Stone Patients

Laparoscopic versus Open Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Single Institute Comparative Analysis

Laparoscopic radical cystectomy: neobladder or ileal conduit, debate still goes on

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