Laparoscopic Radical Cystectomy Versus Extraperitoneal Radical Cystectomy: Is the Extraperitoneal Technique Rewarding?

Zhao, Junjie; Zeng, Shuxiong; Zhang, Zhensheng; Zhou, Tong; Yang, Bo; Song, Ruixiang; Sun, Yinghao; Xu, Chuanliang

doi:10.1016/j.clgc.2015.01.006

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…Surgery induced inflammatory reactions that arise between the small bowel and the deperitonealized pelvic wall will lead to small bowel palsy, obstruction, ileus, or constipation (8). The results of Zhao J et al (9) also showed the existence of a nonperitonealized pelvis in the TLRC group adversely affected the functional recovery of the bowel, which is similar with our observations. Keeping the integrity of the peritoneal cavity can prevent the inflammatory reactions induced by the deperitonealized pelvic wall with the small bowel (10).…”

Section: Discussionsupporting

confidence: 92%

Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience

Feng

Song

et al. 2016

Int. braz j urol.

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Objective:This study reports the initial experience of extraperitoneal laparoscopic radical cystectomy (ELRC) and compared with transperitoneal laparoscopic radical cystectomy (TLRC) in the treatment of selected elderly bladder cancer patients.Patients and Methods:A total of forty male bladder cancer patients who underwent ELRC (n=19) or TLRC (n=21) with ureterocutaneostomy were investigated. Demographic parameters, perioperative variables, oncological outcomes and follow-up data were retrospectively analyzed.Results:A significantly shorter time to exsufflation (1.5±0.7 vs 2.1±1.1 d; p=0.026) and liquid intake (1.8±0.9 vs 2.8±1.9 d; p=0.035) were observed in the ELRC group compared with the TLRC group. The incidence of postoperative ileus in the ELRC group was lower than the TLRC group (0 vs 9.5%). However, the difference had no statistical significance (p>0.05). The removed lymph node number in the ELRC group was significantly lower than the TLRC group (p<0.001). No significant differences were observed between the two groups in the overall and cancer-free survival rates (p>0.05).Conclusions:ELRC seems to be a safe and feasible surgical strategy for the selected elderly bladder cancer patients with ≤ T2 disease. The surgical and oncological efficacy of the ELRC is similar to that of the TLRC, but with faster intestinal function recovery. Further studies with a large series including different urinary diversions are needed to confirm our results and to better evaluate the benefit of ELRC in bladder cancer patients.

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Section: Discussionsupporting

confidence: 92%

Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience

Feng

Song

et al. 2016

Int. braz j urol.

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“…The ELRC group showed significantly shorter interval to flatus (35.5 ± 9.7 vs 42.7 ± 10.8 h, p < 0.001), shorter days to solid food (4.8 ± 1.3 vs 6.0 ± 1.7 days, p < 0.01), shorter LOS (12.7 ± 2.0 vs 14.0 ± 2.7 days, p < 0.01), and lower incidence of postoperative gastrointestinal complications (2.1% vs 14.9%, p < 0.05), compared to the TLRC group. These results were consistent with the concept of utilizing laparoscopic surgery in extraperitoneal radical cystectomy to reduce complications, as proposed by Zhao et al [ 19 ]. As shown in numerous studies, laparoscopic or robotic assisted radical cystectomy with ICUD has been proven feasible and safe relative to conventional extracorporeal urinary diversion (ECUD) or open radical cystectomy (ORC) [ 5 , 20 – 22 ].…”

Section: Discussionsupporting

confidence: 92%

Extraperitoneal laparoscopic radical cystectomy with intracorporeal neobladder: a comparison with transperitoneal approach

et al. 2022

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Background Bladder cancer is one of the most common genitourinary cancers. Traditional transperitoneal radical cystectomy is the gold standard treatment for muscle-invasive bladder cancer. Our study was to compare the perioperative and oncological outcomes of extraperitoneal laparoscopic radical cystectomy (ELRC) with intracorporeal neobladder versus transperitoneal urinary diversion for bladder cancer. Method A total of 113 patients who underwent laparoscopic radical cystectomy performed at our center were included in this retrospective study. The perioperative data of the extraperitoneal laparoscopic radical cystectomy (ELRC) with intracorporeal urinary diversion (ICUD) and transperitoneal laparoscopic radical cystectomy (TLRC) with ICUD groups were compared. The demographic, perioperative, oncological, and complication data were collected and analyzed. Results In total, 113 patients were enrolled for the final analysis. The median follow-up period was 22 months. The ELRC group had shorter interval to flatus (p < 0.001), solid food (p < 0.001), shorter length of hospital stay (p < 0.01), and fewer early gastrointestinal complications (p < 0.05). Furthermore, urinary continence, recurrence-free, cancer-specific, and overall survival rates and recurrence patterns did not significantly differ. Conclusions Surgical technique of ELRC with ICUD can achieve the established oncologic criteria of TLRC, and such technique can improve perioperative and early postoperative outcomes.

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“…However, for beginners the anatomy is unfamiliar, which will increase the difficulty of the operation. Secondly, as emphasized by Zhao et al [32], urinary extravasation from either the pouch suture or the anastomotic site during the postoperative period is not uncommon, and some patients are even asymptomatic. Urine leakage can be controlled by simple extraperitoneal drainage or transurethral intubation when necessary.…”

Section: Discussionmentioning

confidence: 97%

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

Yang

Zhang

Zhao

et al. 2022

Urology

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Laparoscopic Radical Cystectomy Versus Extraperitoneal Radical Cystectomy: Is the Extraperitoneal Technique Rewarding?

Cited by 13 publications

References 33 publications

Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience

Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience

Extraperitoneal laparoscopic radical cystectomy with intracorporeal neobladder: a comparison with transperitoneal approach

Extraperitoneal Laparoscopic Radical Cystectomy With Preservation of Fertility for the Treatment of Ewing Sarcoma: The First Report of a Reliable Surgical Method

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