Laparoscopic Radical Cystoprostatectomy: Our Experience in A Consecutive Series of 10 Patients with a 3 Years Follow-Up

Simonato, Alchiede; Gregori, Andrea; Lissiani, A.; Bozzola, A.; Galli, Stefano; Gaboardi, Franco

doi:10.1016/j.eururo.2005.02.011

Cited by 73 publications

(18 citation statements)

References 24 publications

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“…Table 4 gives an overview of the current oncological results with LRC in literature and depicts the results of the ORC series from Hautmann et al [3] and our LRC series [10,11,25,26,27,28,29]. These results are not directly comparable as only our series is without neoadjuvant and adjuvant therapy.…”

Section: Discussionmentioning

confidence: 43%

Oncologic Outcome after Laparoscopic Radical Cystectomy without Neoadjuvant or Adjuvant Therapy with a Median Follow-Up of 32 Months

Hermans

Fossion

2013

Urol Int

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Introduction: We report the oncological outcome after laparoscopic radical cystectomy (LRC) and standard laparoscopic pelvic lymph node dissection (PLND) without neoadjuvant or adjuvant therapy in the treatment of bladder cancer with a median follow-up of 32 months. Materials and Methods: From September 2006 to January 2011, 40 consecutive patients underwent an LRC and standard laparoscopic PLND, and were included in this prospective observational cohort study. No patient received neoadjuvant or adjuvant therapy. Demographic, perioperative, complication, histopathologic and survival data were collected and analyzed. Results: The 2002 TNM staging for the tumors were: pT0, 4 cases; pTis, 5 cases; pT1, 4 cases; pT2, 7 cases; pT3, 13 cases; pT4, 7 cases. Positive surgical margins were reported in 3 patients (7.5%) and lymph node involvement in 9 patients (23.7%). No patient was lost to follow-up. The overall, cancer-specific and recurrence-free survival rates were 53, 73 and 70% with a median follow-up of 32 months. Eleven patients (27.5%) died of metastatic disease or local recurrence. Nonorgan-confined disease (≥pT3) and primary lymph node involvement (pN+) were significantly associated with worse overall, cancer-specific and recurrence-free survival rates. Conclusion: We report acceptable mid-term and promising long-term oncological outcome after LRC and standard laparoscopic PLND without neoadjuvant or adjuvant therapy.

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Section: Discussionmentioning

confidence: 43%

Oncologic Outcome after Laparoscopic Radical Cystectomy without Neoadjuvant or Adjuvant Therapy with a Median Follow-Up of 32 Months

Hermans

Fossion

2013

Urol Int

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“…A clear beneWt of LRC concluded from these studies is a reduction in intraoperative blood loss and postoperative analgesic requirement. Long-term oncological outcome data of LRC is yet to be made available, however 3-year follow-up data shows a comparable oncological outcome to ORC in one study and marginally worse outcome in the other [5,11]. LRC is a technically demanding procedure with a steep learning curve.…”

Section: Discussionmentioning

confidence: 86%

“…Histopathology revealed transitional cell carcinoma in all the patients (pT2a-1, pT2b-3, pT3a-2). The mean number of nodes removed was 12 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). One patient had a node-positive disease.…”

Section: Resultsmentioning

confidence: 98%

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

2008

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One of the recent developments in the da Vinci robot surgical system is the introduction of a more ergonomic four-arm robot. We report our experience of robotic radical cystectomy (RRC) for bladder cancer using the four-arm da Vinci(®) S(TM) robot (Intuitive Surgical, Sunnyvale, CA, USA). Beginning September 2006, we performed robotic radical cystectomy and bilateral pelvic lymphadenectomy in six patients with muscle-invasive bladder cancer using da Vinci(®) S(TM) robot. Ileal conduit diversion was made in five patients, and sigmoid orthotopic neobladder in one patient. The operating surgeon used the fourth arm for various steps such as bladder retraction for defining vascular pedicles, separating cystoprostatectomy specimen off the rectum, and while performing urethroneovesicostomy. The mean operative time was 12, 148, 44, and 126 min for docking, cystectomy, lymphadenectomy, and urinary diversion, respectively. Median blood loss was 200 ml. Mean hospital stay was 9.2 days. Surgical margins were negative in all the patients. The mean number of nodes removed was 12 (4-19). Histopathology revealed transitional cell carcinoma in all the patients (pT2a-1, pT2b-3, pT3a-2). Robotic radical cystectomy is feasible with new four-arm da Vinci(®) S(TM) surgical system. The operating surgeon can use the fourth arm of the robot as a substitute for the second assistant during the procedure. However, a patient-side surgeon with adequate training in laparoscopic skills is mandatory.

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“…Simonato et al [7] reported an average blood loss of 414 ml in the laparoscopic group, while Cathelineau et al [23] reported a median blood loss of 550 ml (range 100-2,000). In our study the mean blood loss was 294 ml in LRCP and 423 ml in ORCP (p = 0.0021).…”

Section: Discussionmentioning

confidence: 99%

“…However, the feasibility and safety of laparoscopic radical cystoprostatectomy (LRCP) has been demonstrated by several reports in the literature that used different types of urinary diversions [1,2,3,4,5]. Deger et al [6] and Simonato et al [7] reported short- and intermediate-term data for oncologic and physiologic outcomes of LRCP. Although the advantages of LRCP had been demonstrated with less blood loss [8], it was associated with prolonged operation time, and the real benefits of LRCP over ORCP were introduced.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Open and Laparoscopic Radical Cystoprostatectomy Combined with Orthotopic Neobladder: A Single-Surgeon Experience

et al. 2013

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Aim: To compare the outcomes of laparoscopic (LRCP) and open radical cystoprostatectomy (ORCP) with orthotopic urinary diversion for muscle-invasive organ-confined bladder cancer by a single surgeon. Patients and Methods: Prospectively documented 15 LRCP and 15 ORCP patients, followed for at least 3 years, were included in our study. The demographic parameters of patients, preoperative radiologic staging, previous operations, surgical outcomes, complications, oncologic results and intermediate-term follow-up, postoperative chemotherapy and follow-up periods were recorded and evaluated. Results: The mean oncologic follow-up was 3 years. Transfusion rate, estimated blood loss, oral intake and narcotic analgesic requirement were statistically less in the LRCP group (p < 0.05). However, operation time and hospital stay were similar in both groups. The complication rates were not significantly different between the two groups. The mean number of dissected lymph nodes was 20.0 ± 1.7 in the ORCP and 22.6 ± 2.0 in the LRCP group. One patient in each group had a margin positive for bladder cancer. Conclusions: The laparoscopic approach may be feasible for muscle-invasive organ-confined bladder cancer. Furthermore, LRCP provides less blood loss, early oral intake and postoperative pain management. Additionally, continence and sexual function may be provided by LRCP as with ORCP.

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Laparoscopic Radical Cystoprostatectomy: Our Experience in A Consecutive Series of 10 Patients with a 3 Years Follow-Up

Cited by 73 publications

References 24 publications

Oncologic Outcome after Laparoscopic Radical Cystectomy without Neoadjuvant or Adjuvant Therapy with a Median Follow-Up of 32 Months

Oncologic Outcome after Laparoscopic Radical Cystectomy without Neoadjuvant or Adjuvant Therapy with a Median Follow-Up of 32 Months

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

Evaluation of Open and Laparoscopic Radical Cystoprostatectomy Combined with Orthotopic Neobladder: A Single-Surgeon Experience

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