Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes
Purpose: With the increasing application of laparoscopic or robot-assisted radical cystectomy, a reliable and promising method is needed for reducing postoperative complications. We describe the short-term outcomes of totally extraperitoneal laparoscopic radical cystectomy (TELRC) with extraperitone...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Urological Association
2022-09-01
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| Series: | Investigative and Clinical Urology |
| Subjects: | |
| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20220156 |
| _version_ | 1811275862441459712 |
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| author | Guanqun Zhu Zongliang Zhang Kai Zhao Xinbao Yin Yulian Zhang Zhenlin Wang Chen Li Yuanming Sui Xueyu Li Han Yang Nianzeng Xing Ke Wang |
| author_facet | Guanqun Zhu Zongliang Zhang Kai Zhao Xinbao Yin Yulian Zhang Zhenlin Wang Chen Li Yuanming Sui Xueyu Li Han Yang Nianzeng Xing Ke Wang |
| author_sort | Guanqun Zhu |
| collection | DOAJ |
| description | Purpose: With the increasing application of laparoscopic or robot-assisted radical cystectomy, a reliable and promising method is needed for reducing postoperative complications. We describe the short-term outcomes of totally extraperitoneal laparoscopic radical cystectomy (TELRC) with extraperitoneal pelvic lymph node dissection (EPLND) and extraperitoneal ileal orthotopic neobladder (EION) techniques.
Materials and Methods: From January 2020 to December 2021, we performed TELRC and EPLND with EION in 72 patients in our center. The accompanying video highlights our novel techniques. The patients’ demographic data, intraoperative data, and perioperative complications were collected, and short-term oncological and functional results are reported.
Results: All procedures were technically successful without conversion to open surgery. The patients’ mean body mass index was 26.22±5.71. Median age was 57.51±12.34 years. Average hospital stay was 13.78±4.62 days. Median intraoperative blood loss was 112.92±88.56 mL. No blood transfusion was needed during the operations and only one blood transfusion was performed during the perioperative period. Mean operating time was 259.44±49.84 minutes. Average cost was US$9,875.71±1,873.08. Postoperative short-term complications included short-term ileus (n=3), infection (n=13), leakage of urine (n=11), and lymph fistula (n=7). One late complication of unilateral vesicoureteral anastomotic stenosis occurred. The mean follow-up was 13.42±8.77 months, and no patient developed local or systemic recurrence. The short-term follow-up and small cohort of patients limited our evaluation of outcomes.
Conclusions: TELRC with PLND and EION was technically feasible and clinically promising, with a reduced potential harm of postoperative complications. Long-term follow-up and a larger cohort of patients are needed for further study. |
| first_indexed | 2024-04-12T23:46:26Z |
| format | Article |
| id | doaj.art-e6a8612495534e19acb7cadf47ee573c |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-04-12T23:46:26Z |
| publishDate | 2022-09-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-e6a8612495534e19acb7cadf47ee573c2022-12-22T03:11:52ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2022-09-0163552353010.4111/icu.20220156Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomesGuanqun Zhu0https://orcid.org/0000-0001-7841-8026Zongliang Zhang1https://orcid.org/0000-0002-5370-9430Kai Zhao2https://orcid.org/0000-0001-7725-4760Xinbao Yin3https://orcid.org/0000-0002-4934-4037Yulian Zhang4https://orcid.org/0000-0002-0199-2801Zhenlin Wang5https://orcid.org/0000-0003-3640-4747Chen Li6https://orcid.org/0000-0002-7744-8677Yuanming Sui7https://orcid.org/0000-0002-7417-966XXueyu Li8https://orcid.org/0000-0001-9443-0551Han Yang9https://orcid.org/0000-0002-0939-0039Nianzeng Xing10https://orcid.org/0000-0003-4370-3008Ke Wang11https://orcid.org/0000-0002-5073-4200Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Gynecology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Department of Urology, the Affiliated Hospital of Qingdao University, Qingdao, China.Purpose: With the increasing application of laparoscopic or robot-assisted radical cystectomy, a reliable and promising method is needed for reducing postoperative complications. We describe the short-term outcomes of totally extraperitoneal laparoscopic radical cystectomy (TELRC) with extraperitoneal pelvic lymph node dissection (EPLND) and extraperitoneal ileal orthotopic neobladder (EION) techniques. Materials and Methods: From January 2020 to December 2021, we performed TELRC and EPLND with EION in 72 patients in our center. The accompanying video highlights our novel techniques. The patients’ demographic data, intraoperative data, and perioperative complications were collected, and short-term oncological and functional results are reported. Results: All procedures were technically successful without conversion to open surgery. The patients’ mean body mass index was 26.22±5.71. Median age was 57.51±12.34 years. Average hospital stay was 13.78±4.62 days. Median intraoperative blood loss was 112.92±88.56 mL. No blood transfusion was needed during the operations and only one blood transfusion was performed during the perioperative period. Mean operating time was 259.44±49.84 minutes. Average cost was US$9,875.71±1,873.08. Postoperative short-term complications included short-term ileus (n=3), infection (n=13), leakage of urine (n=11), and lymph fistula (n=7). One late complication of unilateral vesicoureteral anastomotic stenosis occurred. The mean follow-up was 13.42±8.77 months, and no patient developed local or systemic recurrence. The short-term follow-up and small cohort of patients limited our evaluation of outcomes. Conclusions: TELRC with PLND and EION was technically feasible and clinically promising, with a reduced potential harm of postoperative complications. Long-term follow-up and a larger cohort of patients are needed for further study.https://www.icurology.org/pdf/10.4111/icu.20220156cystectomylaparoscopesurinary bladder neoplasmsurinary diversions |
| spellingShingle | Guanqun Zhu Zongliang Zhang Kai Zhao Xinbao Yin Yulian Zhang Zhenlin Wang Chen Li Yuanming Sui Xueyu Li Han Yang Nianzeng Xing Ke Wang Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes Investigative and Clinical Urology cystectomy laparoscopes urinary bladder neoplasms urinary diversions |
| title | Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes |
| title_full | Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes |
| title_fullStr | Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes |
| title_full_unstemmed | Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes |
| title_short | Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes |
| title_sort | laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach our initial technique and short term outcomes |
| topic | cystectomy laparoscopes urinary bladder neoplasms urinary diversions |
| url | https://www.icurology.org/pdf/10.4111/icu.20220156 |
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