[Laparoscopic radical cystectomy. The new gold standard for bladder carcinoma?]. / Es la cistectomía radical laparoscópica el nuevo standard de oro para el cáncer de vejiga?
Arch Esp Urol
; 62(9): 737-44, 2009 Nov.
Article
em Es
| MEDLINE
| ID: mdl-19955599
ABSTRACT
SUMMARY OBJECTIVES:
The experience of a renowned Latin American laparoscopic center is reported and the differences with the open technique are thoroughly discussed.METHODS:
During a 7 year period a total of 85 laparoscopic cystectomies were performed; in 92%of the cases urinary diversion was performed extracorporeally. This accounted for 14 anterior exanterations, 50 radical cystoprostatectomies, 7 radical cystectomies and 14 simple cystectomies. Male to female ratio was 31. Mean patient age was 63 years (range 29 to 83). Mean Body Mass Index (BMI) was 28 kg/m2(range 20 to 47). Operative data and long term results are analyzed.RESULTS:
All 85 procedures were completed laparoscopically without need for conversion to open surgery. Orthotopic neobladder, Santiago pouch, Studer, Fontana and Le Bag were performed in 42, 13, 16, 12 and 1 case respectively. Ileal conduit, Indiana pouch and Mainz II were employed in 24, 10 and 9 cases respectively. All Mainz II were performed intracorporeally. Mean operative time and blood loss were 279 minutes (range 180 to 375) and 436 ml (range 50 to 1.500) respectively. A total of 8 patients (11%) presented perioperative complications 5 vascular lesions, 2 eviscerations and 2 septicemias. Delayed complications were observed in 7 cases (9%); 3 urinary sepsis, 1 ureteral stenosis, 2 spontaneous ruptures and 1 mesenteric ischemia. Mean hospital stay was 8.8 days (range de 4 to 28). There was no operative mortality. Mean follow-up was 18 months (range 2 to 68 months). Ten patients (13%) presented disease progression and death.CONCLUSIONS:
Laparoscopic radical cystectomy is associated with diminished operative bleeding, time to oral intake and hospital stay. Though this is a reproducible technique it demands a very long learning curve.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Bexiga Urinária
/
Cistectomia
/
Laparoscopia
Limite:
Adult
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Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
Idioma:
Es
Ano de publicação:
2009
Tipo de documento:
Article