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Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes.
Springer, Christopher; Mohammed, Nasreldin; Alba, Stefano; Theil, Gerit; Altieri, Vincenzo Maria; Fornara, Paolo; Greco, Francesco.
Afiliación
  • Springer C; Department of Urology and Kidney Transplantation, Martin-Luther-University, Ernst-Grube-Strasse 40, 06120, Halle/Saale, Germany.
World J Urol ; 32(2): 407-12, 2014 Apr.
Article en En | MEDLINE | ID: mdl-23817890
ABSTRACT

OBJECTIVES:

To report the surgical outcomes of laparoscopic radical cystectomy (LRC) with extracorporeal orthotopic ileal neobladder (OIN) in patients with muscle-invasive urothelial carcinoma of the bladder (UCB). MATERIALS AND

METHODS:

Between October 2009 and December 2011, 37 patients with muscle-invasive UCB underwent a LRC with OIN. Indications included (a) muscle-invasive UCB T2-4a, N0-Nx, M0; (b) high-risk and recurrent non-muscle-invasive tumors; (c) T1G3 plus CIS; and (d) extensive non-muscle-invasive disease that could not be controlled by transurethral resection and intravesical therapy. Demographic data, perioperative, and postoperative variables were recorded and analyzed.

RESULTS:

The median operating time was 330 min, with a median estimated blood loss of 410 ml. Median length of stay was 12 days, and the mean length of the skin incision to extract the specimen and for the configuration of the neobladder was 7 ± 1 cm. The complication rate was 21.6 % (Clavien II). No Clavien III-V complications were reported. Daytime and nocturnal continence were preserved in 95 and 78 %, respectively. No local recurrence or port site metastasis occurred. Median time to disease recurrence was 14 months (IQR 9-24), and 1-year cancer-specific survival was 91.9 %.

CONCLUSIONS:

Laparoscopic radical cystectomy with extracorporeal ileal neobladder is a challenging procedure but technically feasible, allowing low morbidity and oncological safety. Long-term oncological results are required to definitely recognize this procedure as a standard treatment for bladder cancer.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Derivación Urinaria / Vejiga Urinaria / Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales / Cistectomía / Íleon / Músculo Liso / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World J Urol Año: 2014 Tipo del documento: Article País de afiliación: Alemania

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Derivación Urinaria / Vejiga Urinaria / Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales / Cistectomía / Íleon / Músculo Liso / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: World J Urol Año: 2014 Tipo del documento: Article País de afiliación: Alemania