Technique and results in total laparoscopic radical cystectomy with sigmoidorectal pouch (Mainz pouch II) - an initial experience

Bao, Jiguang; Yue, Zhongjin; Wu, Gongjin; Shi, Weixian; Wang, Wei Chun

doi:10.3892/etm.2017.4163

Cited by 5 publications

(9 citation statements)

References 15 publications

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“…After laparoscopic radical cystectomy with standard pelvic lymph node dissection [ 12 ], remove the midline lower abdominal incision, about the length of 6~8 cm; 10~15-cm lengths of the selected sigmoid colon and rectum respectively were folded in inverted U shape, and then, the seromuscular layer was sutured and fixed. Following the outline, the bowel is opened antimesenterically and detubularized with electrocautery; 3/0 polygalactin suture was used to side-to-side anastomosis the inner wall of the sigmoid colon and rectum to form the posterior wall of the new reservoir outside the abdominal cavity.…”

Section: Methodsmentioning

confidence: 99%

Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer

Zheng

Liu

et al. 2021

World J Surg Onc

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Objective To compare perioperative and oncologic outcomes of open modified ureterosigmoidostomy urinary diversion (OMUUD) and intracorporeal modified ureterosigmoidostomy urinary diversion (IMUUD) following laparoscopic radical cystectomy (LRC). Patients and methods We retrospectively reviewed our single institutional collected database patients undergoing LRC from October 2011 to October 2019. The perioperative characteristics were compared between OMUUD and IMUUD, and overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meier method. Results Overall, 84 patients were included. OMUUD and IMUUD were performed in 63 (75%) and 21 (25%) patients, respectively. IMUUD patients demonstrated shorter postoperative length of stay (16.24 ± 3.91 days vs. 18.98 ± 7.41 days, P = 0.033), similar operation time (498.57 ± 121.44 vs. 462.24 ± 99.71, P = 0.175), similar estimated blood loss [400 (200–475) ml vs. 400 (200–700) ml, P = 0.095], and similar overall complication rate within 30 days (19.05% vs. 25.40%, P = 0.848) and 90 days (23.81% vs. 17.46%, P = 0.748). Complete urinary control rate was 87.3% (55/63) in the OMUUD group. In IMUUD, the complete urinary control rate was 90.5% (19/21). There was no significant difference in OS (χ2 = 0.015, P = 0.901) and PFS (χ2 = 0.107, P = 0.743) between the two groups. Conclusion IMUUD postoperative recovery is faster; other perioperative outcomes and oncology results are not significantly different with OMUUD. It is indicated that IMUUD can be utilized safely and effectively in the urinary diversion after LRC.

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Section: Methodsmentioning

confidence: 99%

Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer

Zheng

Liu

et al. 2021

World J Surg Onc

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“…The study was registered in the Chinese Clinical Trial Registry (ChiCTR2300070279). Indications for RARC have been previously described 10,11 . Patient demographics, perioperative data, complications (early ≤ 30 days and late>30 days) classi ed according to Clavien-Dindo, and continence rate were recorded.…”

Section: Study Subjectsmentioning

confidence: 99%

“…However, Mainz pouch II UD (sigma rectum pouch), another type of procedure used to restore continence, is a relatively simple and quick procedure with considerable advantages for certain patients 8,9 . In our clinical practice, the Mainz pouch II UD is thus the principal UD type, and it is employed in surgeries ranging from open to total intracorporeal 10,11 . RARC with Mainz pouch II UD, on the other hand, is uncommon, and no intracorporeal or open approaches to Mainz pouch II UD are known.…”

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confidence: 99%

Perioperative Outcomes and Continence Following Robotic-Assisted Radical Cystectomy with Mainz Pouch II Urinary Diversion in Patients with Bladder Cancer

Jing,

Yang,

Luo

et al. 2023

Preprint

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PURPOSE To present the widely unknown perioperative outcomes and continence statuses of bladder cancer patients following robotic-assisted radical cystectomy (RARC) with Mainz Pouch II urinary diversion (UD). MATERIALS AND METHODS From November 2020 to December 2022, 37 bladder cancer patients who underwent RARC with Mainz pouch II UD were retrospectively assessed (ChiCTR2300070279). Patient demographics, perioperative data, continence, and complications (early ≤ 30 days and late > 30 days) were all documented. A numeric rating scale assessed patient satisfaction with urinary continence 30 days after surgery. RESULTS Of the 37 patients evaluated over a median (range) follow-up period of 11.8 (1.6–24.5) months. The median (range) age was 65 (40–81) years. The median (range) time to urinary continence after surgery was 2.3 (1.5-6) months. Of the 37 patients, 31 (83.6%) were continent both during the day and at night, 34 (91.9%) were continent during the day, 32 (86.5%) were continent at night, 35 (94.6%) were satisfied with their urinary continence status, and 21 (56.8%) were very satisfied. The mean (range) voiding frequency was 6 (4–10) during the day and 3 (2-5.5) at night. Five (13.5%) patients experienced late complications. CONCLUSIONS Mainz pouch II UD following RARC in bladder cancer patients results in a satisfactory continence rate, and the intracorporeal approach to Mainz pouch II UD works better for female patients due to its reduced invasiveness. TRIAL REGISTRATION ChiCTR2300070279; Registration: 07/04/2023, Last updated version: 01/06/2023. Retrospectively registered.

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“…In previous clinical studies, the Mainz Ⅱ rectosigmoid pouch procedure was performed with minimally invasive surgical techniques in highly selective patients who were appropriately informed of the potential risks. [5][6][7][8][9] The robot-assisted intracorporeal Mainz Ⅱ rectosigmoid pouch procedure, which has not yet been reported in any country, remains technically challenging, and the surgical procedures need to be explored.…”

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Robot‐assisted radical cystectomy with intracorporeal Mainz Ⅱ rectosigmoid pouch for muscle‐invasive bladder cancer

Wang

Xiao

et al. 2021

Robotics Computer Surgery

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Background: To report the surgical techniques and results of robot-assisted radical cystectomy (RARC) with intracorporeal Mainz Ⅱ rectosigmoid pouch at our centre. Methods: Two female patients were treated with this procedure. Construction of the pouch was divided into four main steps: incision of the rectum and sigmoid colon, closure of the posterior wall of the pouch, reimplantation of the ureters at the bottom of pouch in an anti-reflux manner, and closure of the anterior wall. Surgical results and perioperative complications were assessed. Results:The operations were performed completely intracorporeally. No perioperative complications were observed. Postoperatively, high-grade invasive urothelial carcinoma was detected. On postoperative day 60, no bilateral ureteral dilation was detected. Two patients demonstrated total continence. Clinical recurrence was not observed during the follow-up period.Conclusions: With careful patient selection, robot-assisted intracorporeal Mainz Ⅱ rectosigmoid pouch might be a simple minimally invasive surgical technique to be evaluated in repeated applications. K E Y W O R D Sbladder cancer, continent urinary diversion, Mainz Ⅱ rectosigmoid pouch, robot-assisted radical cystectomy | INTRODUCTIONWorldwide, bladder cancer is the second most common cancer of the urinary tract and is associated with high morbidity and mortality. Urothelial carcinoma accounts for nearly 90% of all primary bladder tumours. 1,2 Radical cystectomy (RC) is now considered the gold standard for the treatment of muscle-invasive urothelial bladder cancer or high-grade, recurrent non-muscleinvasive bladder tumours. [2][3][4] However, both open radical cystectomy and laparoscopic radical cystectomy with continent or incontinent urinary diversion are standard procedures associated with a risk for severe complications. Conversely, robot-assisted radical cystectomy (RARC) has been reported to reduce morbidity and mortality after RC. Due to inexperience with intracorporeal urinary diversion, most surgeons have performed RARC with extracorporeal urinary diversion. 4 As the technology develops, urinary diversion should be performed intracorporeally along with RC.

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Technique and results in total laparoscopic radical cystectomy with sigmoidorectal pouch (Mainz pouch II) - an initial experience

Cited by 5 publications

References 15 publications

Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer

Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer

Perioperative Outcomes and Continence Following Robotic-Assisted Radical Cystectomy with Mainz Pouch II Urinary Diversion in Patients with Bladder Cancer

Robot‐assisted radical cystectomy with intracorporeal Mainz Ⅱ rectosigmoid pouch for muscle‐invasive bladder cancer

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