Minilaparotomy Radical Cystoprostatectomy (Minilap RCP) in the Surgical Management of Urinary Bladder Carcinoma: Early Experience

Rawal, Sudhir; Raghunath, SK; Khanna, Samir; Jain, Deepak; Kaul, Rakesh; Kumar, P. S.; Chhabra, Rakesh; Bhushan, Kirti

doi:10.1093/jjco/hyn079

Cited by 6 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[2] Now radical cystectomy and ileal conduit can be performed with an acceptable morbidity and mortality in individuals 80 years of age or older[1] with no statistically significant difference with respect to age. [34] Prolonged hospital stay can be avoided by minimizing the size of incision and performing extraperitoneal radical cystectomy,[56] which helps in early restoration of bowel function as it minimizes bowel handling with decreased postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

Radical cystectomy in octogenarians

et al. 2012

Self Cite

View full text Add to dashboard Cite

This retrospective study evaluates the morbidity and outcome of cystectomy and urinary diversion in octogenarians with invasive bladder cancer. Records of all patients older than 80 years who underwent cystectomy during the last 10 years were analyzed retrospectively. Among 565 cystectomies, 11(< 2%) patients were identified and evaluated for intraoperative and postoperative complications and mortality post surgery. The median age was 82 years. One female and ten male patients were selected. Eight patients were hypertensive, three were diabetic, one had coronary artery disease, two had chronic lung disease and one had depression. Seven patients presented with hematuria, two had lower urinary tract symptoms and two presented with renal failure who were optimized for renal function. All patients had ileal conduit as the form of urinary diversion. Simultaneous urethrectomy was done in two patients. Median surgical time was 5 h. Median hospital stay after surgery was 10 days. Four patients had pneumonitis and one patient developed hemiplegia, but all patients were eventually discharged. One patient expired due to stent septicemia within one month after discharge. Follow-up ranged from four months to five years. Three patients expired three years after surgery—one due to disease recurrence and the other two due to unrelated cause. One patient was lost to follow-up and six patients are doing well. Our results support the use of cystectomy in octogenarians with invasive bladder cancer, which has acceptable morbidity and mortality, and offers the best chance for sustained disease-free quality survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Radical cystectomy in octogenarians

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…According to this, patients not undergoing MinilapRC in the last time frame were included in the MinilapRC group for analysis. Studies comparing minimally invasive approaches with ORC are listed in Table 2[4,7,11–22].…”

Section: Discussionmentioning

confidence: 99%

“…As first reported by Rawal et al . [7], a Minilap approach might also be feasible in RC (MinilapRC).…”

Section: Introductionmentioning

confidence: 99%

Mini‐laparotomy approach to radical cystectomy

et al. 2011

View full text Add to dashboard Cite

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? In the recent decade minimally invasive endoscopically approaches have been suggested as a way to reduce morbidity following radical cystectomy. The present study suggests that the same advantages found, when comparing endoscopical cystectomy to classical open cystectomy, can be achieved by reducing the wound length of the open approach. OBJECTIVE To investigate the feasibility of performing radical cystectomy (RC) through a mini‐laparotomy and to evaluate the effect of a smaller incision on wound problems, immediate postoperative pain, bowel function and length of hospital stay (LOS). PATIENTS AND METHODS Two consecutive cohorts of patients, one with 75 patients undergoing open RC (ORC) with lymph node dissection up to the aortic bifurcation through a conventional long midline incision and one with 75 patients undergoing RC through a mini‐laparotomy (MinilapRC) of intentionally <8–10 cm. Patient characteristics, operative duration, estimated blood loss (EBL), incidence and severity of wound problems, return of bowel function, amount of analgesics needed and LOS were analysed according to the intention‐to‐treat principle. RESULTS The demographic characteristics of the two groups were similar. An incision of ≤10 cm was made in 65% of the patients in the MinilapRC group with a median (range) length of incision of 9 (6.5–19) cm. In the final third of patients operated on in the MinilapRC group, 76% had an incision of ≤8 cm. The operative duration and EBL were not significantly different between the groups. Wound problems were significantly fewer, bowel function was restored more quickly and the need of postoperative analgesics was less in the MinilapRC group. In the MinilapRC group LOS was reduced by a median of 3 days. CONCLUSION MinilapRC is feasible in most patients without increasing operative duration. The reduced incision length reduces postoperative morbidity.

show abstract

“…Smaller abdominal incision and extraperitoneal approach minimizes tissue handling and may help early bowel movement, early mobilization and subsequently decreased perioperative systemic and local complications. 2,7 Patient undergoing major surgeries may present peri-operatively with local and or systemic complication leading to mortality. To minimize morbidity and mortality surgical techniques and approaches have evolved as we have adopted Minilaparatomy extraperitoneal approach RCP.…”

Section: Operative Procedurementioning

confidence: 99%

Mini-laparatomy radical cysto-prostatectomy for urinary bladder carcinoma

et al. 2020

View full text Add to dashboard Cite

Introduction: Open radical cysto-prostatectomy (RCP) is the gold standard for invasive urinary bladder cancer in male. Though minimal invasive technique like laparoscopic or robotic assisted surgery is gaining popularity for surgical management in developed countries, open mini laparotomy is equally effective with similar oncological outcome and morbidity result. Our study aims to evaluate the feasibility of Mini-laparotomy RCP with ileal conduit (IC) or neobladder. Methods: This is a descriptive cross-sectional study of 25 patients conducted from October 2016 to December 2019. Nineteen patients had muscle invasive urinary bladder cancer (MIBC), four had multifocal high grade non-muscle invasive bladder cancer (NMIBC) and two were BCG failure patients. Nineteen patients underwent RCP with IC and six with RCP and ileal Neobladder. We analyzed technical difficulty, operative time, blood loss, peri-operative complication for minilaparotomy RCP. Results: The mean age of patients was 63.2 years (46-81years). The mean operative time was 274 minute (180-420 minutes) with mean blood loss of 470 ml (300-2000 ml). Mean post-operative ileus was observed for 2.8 days (2-4 days). All patients stayed in the hospital for mean days of 12.84 (7 to 25 days). All patients were mobilized early with mean intensive care unit (ICU) stay of 2.52 days. Mean lymph node extraction was 17.6. Two patients died of renal failure and hyperosmolar diabetes mellitus. Conclusion: Minilaparatomy RCP is a feasible option in terms of early recovery with acceptable morbidity without compromising the oncological principles.

show abstract

Minilaparotomy Radical Cystoprostatectomy (Minilap RCP) in the Surgical Management of Urinary Bladder Carcinoma: Early Experience

Cited by 6 publications

References 11 publications

Radical cystectomy in octogenarians

Radical cystectomy in octogenarians

Mini‐laparotomy approach to radical cystectomy

Mini-laparatomy radical cysto-prostatectomy for urinary bladder carcinoma

Contact Info

Product

Resources

About