Laparoscopic intracorporeal ileal conduit after laparoscopic radical cystectomy: A modified technique to facilitate ureteroenteric anastomosis

Kanno, Toru; Kobori, Go; Shibasaki, Noboru; Moroi, Seiji; Akao, Tetsuyuki; Yamada, Hitoshi

doi:10.1111/iju.13782

Cited by 6 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is thought that ureteroenteric anastomosis during laparoscopic ICUD‐IC is more difficult than that during laparoscopic ECUD‐IC or robotic ICUD‐IC, but our modified anastomotic technique that we have previously reported makes ureteroenteric anastomosis easier 9 . In the current study, our modified technique of ureteroenteric anastomosis was applied in 44 out of 72 ICUD‐IC patients.…”

Section: Discussionmentioning

confidence: 85%

“…Recently, we reported a modified technique that can facilitate ureteroenteric anastomosis during pure laparoscopic ICUD‐IC after LRC 9 . In the present study, we aimed to compare the perioperative and oncological outcomes of ICUD‐IC versus ECUD‐IC after LRC for bladder cancer in a multicenter cohort in Japan using the propensity score matching method.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

et al. 2020

Self Cite

View full text Add to dashboard Cite

Abbreviations & Acronyms ASA = American Society of Anesthesiologists Cr = creatine ECUD = extracorporeal urinary diversion ECUD-IC = extracorporeal ileal conduit urinary diversion ERAS = enhanced recovery after surgery Hb = hemoglobin ICUD = intracorporeal urinary diversion ICUD-IC = intracorporeal ileal conduit urinary diversion IQR = interquartile range LRC = laparoscopic radical cystectomy RARC = robot-assisted radical cystectomy SD = standard deviation Objectives: To compare the perioperative and oncological outcomes of pure laparoscopic intracorporeal ileal conduit urinary diversion versus extracorporeal ileal conduit urinary diversion after laparoscopic radical cystectomy for bladder cancer in a multicenter cohort in Japan. Method: A total of 455 patients who underwent laparoscopic radical cystectomy carried out at 10 institutions were included in this retrospective study. The perioperative data of the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups were compared using the propensity score matching method. The Kaplan-Meier curves were obtained to elucidate time to ureteroenteric stricture, reoperation, recurrence and survival. Results: In total, 72 matched pairs were evaluated for the final analysis. The median follow-up period was 28 and 23 months in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively. The operative time in the intracorporeal ileal conduit urinary diversion group was approximately 1 h longer than that in the extracorporeal ileal conduit urinary diversion group. The early and late postoperative complication rates were similar in both groups, except for the reduced wound-related complication rates in the intracorporeal ileal conduit urinary diversion group. The median days to regular oral food intake were 4 and 5 days in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively (P = 0.014). No significant difference was noted in the occurrence of ureteroenteric strictures and reoperation rate. Furthermore, recurrence-free, cancerspecific, and overall survival rates and recurrence patterns did not significantly differ. Conclusions: Laparoscopic intracorporeal ileal conduit urinary diversion is a safe, feasible and reproducible procedure with similar postoperative complication rates, ureteroenteric stricture rate and oncological outcomes when compared with extracorporeal ileal conduit urinary diversion, but faster postoperative bowel recovery and decreased wound-related complication rates.

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Limited PLND included only obturator nodes. Urinary diversion was carried out mainly by the extracorporeal method, but the intracorporeal method was also carried out at four institutions …”

Section: Methodsmentioning

confidence: 99%

“…Urinary diversion was carried out mainly by the extracorporeal method, but the intracorporeal method was also carried out at four institutions. 10 Patients with distant metastasis before surgery, incomplete resection during LRC and perioperative death within 90 days postoperatively were excluded. The sites of recurrence were classified as distant (lung, liver, bone, brain, adrenal, extrapelvic lymph node and abdominal implants within the abdominal cavity), local (cystectomy bed, pelvis lymph node and common iliac lymph node) and urinary tract (upper tract and urethra).…”

Section: Methodsmentioning

confidence: 99%

Oncological outcomes and recurrence patterns after laparoscopic radical cystectomy for bladder cancer: A Japanese multicenter cohort

et al. 2020

Self Cite

View full text Add to dashboard Cite

Objective To investigate oncological outcomes and recurrence patterns after laparoscopic radical cystectomy for bladder cancer in a Japanese multicenter cohort, and to explore the risk factors associated with recurrences due to tumor dissemination. Method Laparoscopic radical cystectomies carried out at 10 institutions were included in this retrospective study. Multivariate analyses were carried out to identify the clinical parameters associated with overall recurrences together with specific recurrence types. Kaplan–Meier curves were created to elucidate time to recurrence and survival. Results A total of 411 patients were included after the final analysis. Postoperative pathology was T2 or higher in 196 patients (48%), and lymph node metastasis was present in 46 patients (11%). The median follow‐up period was 23 months, and the 2‐year recurrence‐free and cancer‐specific survival rates were 71.0% and 84.7%, respectively. The recurrence sites involved distant metastasis in 75 patients (18%), local recurrence in 52 patients (13%) and urinary tract recurrence in eight patients (2%). When local recurrence at the cystectomy bed (28 patients; 7%) and abdominal recurrence including peritoneal carcinomatosis or port site recurrence (17 patients; 4%), which might be caused by tumor dissemination, were combined into a single group, prolonged surgical time was a significant risk factor, in addition to high pathological stage (T3–4 and/or positive lymph nodes), positive surgical margins, and variant histology by both univariate and multivariate analyses. Conclusions Our study findings suggest that recurrences after laparoscopic radical cystectomy might be caused by tumor dissemination, and attention should be paid to avoid prolonged surgical time in laparoscopic radical cystectomy.

show abstract

“…As the authors stated, the substantial disadvantage of pure laparoscopy is the difficulty in the limited working field, especially in the ureteroenteric anastomosis. 5 In this regard, the majority of urologists agree with the benefit of robotic surgery for ICUD-IC. However, no level 1 evidence supports the superiority of the robotic ICUD-IC over the pure laparoscopic ICUD-IC.…”

Section: Editorial Commentmentioning

confidence: 99%

Editorial Comment to Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Hatakeyama

Οhyama

2020

Int J of Urology

View full text Add to dashboard Cite

Laparoscopic intracorporeal ileal conduit after laparoscopic radical cystectomy: A modified technique to facilitate ureteroenteric anastomosis

Cited by 6 publications

References 6 publications

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Oncological outcomes and recurrence patterns after laparoscopic radical cystectomy for bladder cancer: A Japanese multicenter cohort

Editorial Comment to Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan

Contact Info

Product

Resources

About