Laparoscopic radical cystectomy and urinary diversion: fad or future?

Hrouda, David; Adeyoju, Adebanji; Gill, Inderbir S.

doi:10.1111/j.1464-410x.2004.04992.x

Cited by 27 publications

(22 citation statements)

References 26 publications

(27 reference statements)

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“…Hrouda et al reviewed nine papers on LRC [28]. Among a total of 102 patients described in these nine papers, there were no instances of positive surgical margins or inadvertent incisions of the bladder.…”

Section: Surgical Marginsmentioning

confidence: 95%

Laparoscopic radical cystectomy

2009

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Open radical cystectomy with lymph node dissection remains the gold standard treatment for recurrent, high-grade, non-muscle-invasive and for muscle-invasive bladder cancer. The excellent perioperative and long-term results provided by laparoscopic surgery and the advances in instrumentation design have naturally paved the way for development of laparoscopic radical cystectomy (LRC). In this review, surgical and long-term oncological outcomes of LRC are analysed. The advantages of this technique compared with open surgery are described. The differences between pure laparoscopic technique or laparoscopic cystectomy and extracorporeal urinary diversion have also been analysed.

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Section: Surgical Marginsmentioning

confidence: 95%

Laparoscopic radical cystectomy

2009

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“…A estos autores les siguieron otros que lentamente fueron perfeccionando las técnicas hasta llegar a la realización completa de la cirugía en forma intracorpórea 11 . Actualmente diversos centros alrededor del mundo, especializados en laparoscopia urológica avanzada, presentan series que promedian los 80 casos 7,12,13 . A su vez, existen grupos de investigación multicéntricos que se encuentran evaluando los resultados de este procedimiento a corto y largo plazo para poder determinar si existen concretas ventajas de realizar esta cirugía por vía laparoscópica 14 .…”

Section: Discussionunclassified

Cistectomía radical laparoscópica: técnica y resultados en 100 pacientes consecutivos

Vidal-Mora²

2013

Rev Chil Cir

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Radical laparoscopic cystectomy. Experience in 100 patientsBackground: Laparoscopic cystectomy is a less invasive alternative than traditional surgery. Aim: To report our experience with laparoscopic radical cystectomy, the technique, results and complications. Material and Methods: During a 10-year period, 100 consecutive laparoscopic cystectomies for bladder cancer were carried out. The procedures performed were 57 radical cystoprostatectomies, 27 pelvic exenterations, 14 cystectomies with prostate preservation and seven radical cystectomies. An extracorporeal urinary diversion was performed in 92% of cases. Results: The age of patients ranged from 29 to 83 years and the male/female ratio was 3:1. As urinary diversion, an orthotopic reservoir was used in 49 patients, and ileal conduit in 32, Indiana continent reservoir in 10 and intracorporeal Sigma-rectum pouch (Mainz pouch II) in 9 patients. All Mainz II pouches were constructed laparoscopically. Mean operative time and blood loss were 279 minutes (range 180 to 375) and 436 ml (range 50 to 1.500) respectively. Eight patients (11%) had perioperative complications: five had vascular lesions, two had eviscerations and two had septicemia. Delayed complications were observed in seven cases (9%). Three patients had a urinary sepsis, one had a ureteral stenosis, two had spontaneous ruptures of a continent reservoir and one had an intestinal fistula. Mean hospital stay was 8.8 days (range de 4 to 28). One patient died due to an intestinal fistula and secondary peritonitis. Mean followup was 18 months (range 2 to 68 months). Ten patients (13%) had disease progression and died in long-term follow up. Conclusions: Laparoscopic radical cystectomy is associated with a reduced operative bleeding, a short hospital stay and acceptable morbidity.

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“…Hrouda et al [18] reviewed the reported complications in the literature; in total there were few patients, but the complication rate appears to be similar to that of open surgery. In our data, there was a mortality rate of 2% (1/46), rectal injury rate of 0% (0/46), conversion rate of 0% (0/46), fistula formation rate of 2% (2/46) and intestinal obstruction rate of 4% (2/46).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Urinary Diversion for Treatment of Chinese Bladder Cancer Patients

et al. 2007

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Purpose: To present our experience in laparoscopic radical cystectomy with extracorporeal urinary diversion for treatment of Chinese bladder cancer patients. Methods: Between January 2003 and November 2005, 41 men and 5 women with organ-confined muscle-invasive transitional cell carcinoma of the bladder underwent laparoscopic radical cystectomy with the Bricker-type urinary diversion. The age range was 36–71 years. Laparoscopic radical cystectomy and bilateral pelvic lymphadenectomy were performed using five fan-shaped ports by a transperitoneal approach. An ileal conduit diversion was created through the site of specimen retrieval which was the second port at the region of the right pararectus. Results: 46 radical cystectomies with Bricker-type ileal conduits were performed. No conversion to open surgery was necessary. Mean operating time was 220 min (range 120–249 min) for laparoscopic radical cystectomy and 75 min (range 65–120 min) for creating the ileal conduits. Mean estimated blood loss was 276 ml (range 155–567 ml). Two of the 46 patients needed blood transfusion (400 ml each). Mean days to ambulation and oral intake was 4.1 (range 3–5 days) and 3.5 (range 3–6 days), respectively. Mean hospital stay was 17.6 days (range 12–35 days). Mean follow-up was 6.1 months (range 3–19 months). Histopathological examination of the specimens revealed stage T2N0M0 in 18 cases, T3aN0M0 in 14, T3bN0M0 in 9 and T3bN1M0 in 5 (TNM staging). WHO grading: G1 in 2 cases, G2 in 26 cases and G3 in 18 cases. Pelvic metastases appeared in one case and 44 patients are alive and free of disease. Intravenous pyelogram at 3 weeks postoperatively shows no evidence of upper urinary obstruction in 45 patients. Conclusion: Despite technical difficulties, laparoscopic radical cystectomy with Bricker-type urinary diversion is feasible. With more experience in the surgical technique, laparoscopic radical cystectomy with extracorporeal urinary diversion can become an alternative treatment of choice in the selected patients with organ- confined bladder cancer in China.

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Laparoscopic radical cystectomy and urinary diversion: fad or future?

Cited by 27 publications

References 26 publications

Laparoscopic radical cystectomy

Laparoscopic radical cystectomy

Cistectomía radical laparoscópica: técnica y resultados en 100 pacientes consecutivos

Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Urinary Diversion for Treatment of Chinese Bladder Cancer Patients

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