Perioperative Outcomes of Open Extra-peritoneal Versus Laparoscopic Radical Cystoprostatectomy: A single Center Comparative Study.

PURPOSE: To compare 90-day  perioperative complications and pathological outcomes between laparoscopic radical cystectomy (LRC) and extraperitoneal radical cystectomy (EORC) approaches. MATERIALS AND METHODS: All operations were performed in a single high-volume tertiary referee center by the same surgical team.Males ≥ 18 years with pre-cystectomy clinical T1-T3 disease and having undergone an ileal conduit were included. Exclusion criteria included patients with inflammatory bowel disease, previous pelvic and/or abdominal irradiation, neo-adjuvant chemotherapy, and/or clinical T4 disease. Perioperative outcomes such as operative time, estimated blood loss, transfusion rate, hospital stay, and 90-day complications were evaluated. The recovery duration of regular bowel activity, mean stool passage,and ileus rates were recorded. RESULTS: A total of 221 patients met the inclusion criteria(81 LRC and 130 EORC). Demographics and preoperative parameters were comparable. Intraoperative estimated blood lossfavored LRC by a median of 450 mL (200-900) P=.021) vs. a median of 700 mL (300-2900) for EORC. The transfusion rate did not differ between the two groups; %14.8 (N=12) for the LRC and %20.8 (N=27) for EORC (P=.37). The median hospital stay was 9 (4-49) days for EORC and 8 (4-29) days for LRC (P=.011). The need for analgesics to control pain through an epidural catheter was higher for EORC (P=.042). There was no difference in overall complication rates (P=.47). CONCLUSION:   Although LRC appears to have a slight advantage over EORC, both techniques yield satisfactory results in regard to ileus rates and 90-day perioperative complications.

Solid Renal Mass in a Transplanted Allograft Kidney: Mucinous Tubular and Spindle Cell Renal Cell Carcinoma.

Renal transplantation is the main treatment for end-stage kidney disease. Transplantation reduces the mortality rate and increases life quality in this population but cancer in allograft kidney is a major problem. Here, we report a 39-year male who had renal transplantation 10 years ago. On routine follow-up, radiologic imaging revealed a 32 mm mass in the allograft kidney. After partial nephrectomy, histopathologic examination revealed mucinous tubular and spindle cell variant of renal cell carcinoma(MTSCC). To our best knowledge, this is the first case in the literature that underwent partial nephrectomy in the transplanted kidney and was diagnosed with MTSCC. Key Words: Renal mass, Mucinous tubular and spindle cell tumor, Kidney transplantation.

Adenocarcinoma in Orthotopic Neobladder 19 Years After Radical Cystoprostatectomy.

Radical cystectomy and orthotopic neobladder are the most preferred surgical approaches for the treatment of invasive bladder cancer. Secondary tumour of ileum on neobladder is very rare. We report a 67-year man complaining of hematuria with the history of ileal neobladder for 19 years.  An ileal adenocarcinoma of neobladder was detected with transurethral resection. He also had a non-functioning right kidney. A neobladderectomy. with right nephroureterectomy and ureterocutaneostomy was performed. An adenocarcinoma invading subserosal layer was reported. At six months postoperatively, patient was free of recurrence and progression. Seconder tumour of neobladder is a very rare condition. Early diagnosis and excision of neobladder may provide cure. Key Words: Bladder cancer, Urinary diversion, Cystectomy, Ileum, Adenocarcinoma.