Comparison of the short-term efficacy of sequential treatment with intravesical single-port laparoscopic partial cystectomy with bladder preservation or open partial cystectomy in combination with cisplatin plus gemcitabine chemotherapy

Abstract

Abstract. This study aimed to assess the short-term efficacy of sequential therapy for T2/T3a bladder cancer with intravesical single-port laparoscopic partial cystectomy or open partial cystectomy combined with cisplatin plus gemcitabine (GC) chemotherapy in a prospective randomized controlled study. Thirty patients with bladder cancer who underwent open partial cystectomy (group A) or single-port laparoscopic partial cystectomy (group B) and received standard GC chemotherapy were analyzed. Perioperative functional indicators and tumor recurrence during a 1-year postoperative follow-up were compared between the two groups. The baseline characteristics were comparable between the two groups. The mean operative time, amount of blood loss and duration of hospital stay were 90.3 min, 182.0 ml and 7.3 days, respectively, for group A, and 105.3 min, 49.3 ml and 5.8 days, respectively, for group B. No secondary postoperative bleeding, urine leakage, wound infection or other complications were observed in the two groups. Postoperative scarring was not evident in group B. The overall incidence of surgical complications, tumor recurrence rate and complications during chemotherapy in the postoperative follow-up period of 12 months were similar between the two groups. Single-port laparoscopic partial cystectomy surgery is an idea surgical method for the treatment of invasive bladder cancer, with good surgical effect, minimal invasiveness, rapid recovery and short hospital stay. The data from 1-year postoperative follow-up showed that laparoscopic surgery was superior with regard to perioperative bleeding, postoperative recovery and duration of indwelling urinary catheter use. However, regarding the tumor recurrence rate, long-term comparative details are required to determine the effect of laparoscopic surgery. IntroductionAs a surgical method to preserve the bladder, partial cystectomy can be used to achieve full-thickness resection of the bladder wall and complete resection of bladder lesions, in addition to ensuring adequate margins. In the 1950s, partial cystectomy became widely used to treat muscle-invasive bladder cancer (MIBC); however, due to its high recurrence rate (40-78%), together with the development of controllable urinary diversion technology and the application of total cystectomy with preservation of nerves and prostate, radical cystectomy has become the 'gold standard' for the treatment of MIBC (1-3). However, study results from a 30-year period indicate that the postoperative 5-year survival rate of radical cystectomy is only 40-60% (4). In addition, due to the high perioperative mortality rate (1.5-4.2%) and incidence of complications (67%) (5,6), which seriously affect the quality of life following urinary diversion and damage the sexual function of male patients after surgery, the 'gold standard' status for radical cystectomy has been challenged.A study (7) has shown that ~50% of MIBC has dominant or occult local or distant metastasis at the first diagnosis. For these patients whose prognoses cannot ...

Analysis of pathogen distribution and associated risk factors for surgical site infections following laparoscopic urological surgeries

“…Postoperative urinary leakage emerged as a prevalent issue in the infected cohort, potentially exacerbating SSIs through continuous microbial exposure and sustained inflammation. 26 Although not reaching statistical significance, intraoperative blood loss and extended hospital stays were more frequently observed in infected patients, suggesting that these could be important factors to consider in the overall risk assessment.…”

“…Operative factors such as the duration of surgery and complications like urinary leakage were significantly more common in the infected cohort, supporting their roles as contributors to postoperative infections. Postoperative urinary leakage emerged as a prevalent issue in the infected cohort, potentially exacerbating SSIs through continuous microbial exposure and sustained inflammation 26 . Although not reaching statistical significance, intraoperative blood loss and extended hospital stays were more frequently observed in infected patients, suggesting that these could be important factors to consider in the overall risk assessment.…”