|Table of Contents|

Efficacy and safety of transurethral-assisted laparoscopic single-site radical cystectomy combined with orthotopic ileal neobladder

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 09
Page:
1706-1711
Research Field:
Publishing date:

Info

Title:
Efficacy and safety of transurethral-assisted laparoscopic single-site radical cystectomy combined with orthotopic ileal neobladder
Author(s):
WEI Yong1; 2; SHEN Luming1; HU Haibin1; ZHU Chen2; WANG Jun2; GUO Junjie2; SU Jian2; ZHU Qingyi1; 2
1.Department of Urology，the Second Affiliated Hospital of Nanjing Medical University，Jiangsu Nanjing 210011,China;2.Department of Urology，Affiliated Hospital of Nanjing University of Chinese Medicine，Jiangsu Nanjing 210029,China.
Keywords:
radical cystectomy; orthotopic ileal neobladder surgery; bladder cancer; transurethral assistance; laparoendoscopic single-site
PACS:
R737.14
DOI:
10.3969/j.issn.1672-4992.2023.09.023
Abstract:
Objective:To investigate the efficacy and safety of laparoscopic single-site radical cystectomy combined with orthotopic ileal neobladder.Methods:17 bladder cancer patients treated in our center from January 2017 toDecember 2019 were identified，of whom 7 cases underwent single port laparoscopic radical cystectomy plus orthotopic ileal neobladder surgery under the assistance of transurethral approach.The other 10 cases underwent porous laparoscopic radical cystectomy plus orthotopic ileal neobladder were defined in control group.The perioperative data，surgical complications，and postoperative follow-up were analyzed in both groups.Results:Patients in both groups completed the procedure uneventfully without conversion to open surgery.There were no significant differences in age or BMI between the two groups(P>0.05).The mean operative time for uniportal and control groups was (341.4±52.1)min and (333.0±59.5)min，the mean intraoperative blood loss of (206.4±104.6)mL and (190.5±82.3)mL，the mean number of pelvic lymph node dissections as 17(7~22) and 18(12~23)，and the mean postoperative hospital stay of (25.1±5.4)d and (26.8±6.0)d，respectively(P>0.05).However，the uniportal group had lower postoperative VAS pain scores and better incision satisfaction scores than those in the control group(P＜0.05).Among them，patients in the uniportal group had significantly higher maximum urine flow，maximum bladder capacity，and maximum bladder filling volume at 12-month postoperative follow-up than those at 6-month follow-up.While the residual urine volume at 12-month follow-up was lower than that at 6-month follow-up(all P＜0.05).Conclusion:Transurethral-assisted laparoendoscopic single-site radical cystectomy plus orthotopic ileal neobladder is safe and feasible，with relatively well postoperative neobladder function.

References:

［1］王莉萍，王帅，祁小龙，等.机器人辅助与普通腹腔镜根治性膀胱切除术+原位回肠新膀胱术后性功能的对比研究［J］.中华泌尿外科杂志，2020，41(5):356-361. WANG LP，WANG S，QI XL，et al.A comparative study of sexual function preservation after robot-assisted and laparoscopic radical cystectomy and orthotopic bladder reconstruction［J］.Chinese Journal of Urology，2020，41(5):356-361.
［2］杨景添，何旺，黄健.原位新膀胱术改善尿控相关解剖及手术技术［J］.临床泌尿外科杂志，2022，37(11):832-836. YANG JT，HE W，HUANG J.Anatomy and surgical techniques for improving urinary continence of orthotopic ileal neobladder［J］.Journal of Clinical Urology，2022，37(11)：832-836.
［3］时佳子，王志军，琚官群，等.机器人单孔腹腔镜根治性膀胱切除术的初步疗效分析(附9例报告)［J］.中华泌尿外科杂志，2020，41(11):811-814. SHI JZ，WANG ZJ，JU GQ，et al.Robotic single-port radical cystectomy：initial experience with 9 cases report［J］.Chinese Journal of Urology，2020，41(11):811-814.
［4］李伟，田良，刘昊.膀胱癌根治性全膀胱切除术后行不同尿流改道术对患者生活质量的影响［J］.现代肿瘤医学，2019，27(18):3285-3288. LI W，TIAN L，LIU H，et al.Comparative study of different procedures of urinary diversion on the quality of life of patients with bladder cancer after radical total cystectomy［J］.Modern Oncology，2019，27(18):3285-3288.
［5］吴丽媛，杨飞亚，牟廉洁，等.完全腹腔镜根治性膀胱切除术+邢氏原位回肠新膀胱的可行性和疗效［J］.中华泌尿外科杂志，2020，41(2):90-94. WU LY，YANG FY，MU LJ，et al.The feasibility and efficacy of total laparoscopic radical cystectomy with intracorporeal Xing's orthotopic neobladder［J］.Chinese Journal of Urology，2020，41(2):90-94.
［6］于靳，胡敏，许珊，等.根治性膀胱切除并回肠膀胱术不同术前肠道准备措施的效果比较［J］.实用临床医药杂志，2019，23(24):77-79. YU J，HU M，XU S，et al.Comparison of different bowel preparation methods in radical cystectomy and ileal conduit［J］.Journal of Clinical Medicine in Practice，2019，23(24):77-79.
［7］周晓菊，周宏，王安静，等.膀胱全切原位回肠新膀胱与回肠膀胱术对患者生活质量影响的Meta分析［J］.国际泌尿系统杂志，2020，40(1):8-13. ZHOU XJ，ZHOU H，WANG AJ，et al.Effect of ileal orthotopic neobladder and ileal conduit diversion on patient's quality of life after cystectomy：a Meta-analysis［J］.International Journal of Urology and Nephrology，2020，40(1):8-13.
［8］张士伟，邓永明，江波，等.原位新膀胱术后功能保留的探索与思考［J］.中华外科杂志，2022，60(11):969-972. ZHANG SW，DENG YM，JIANG B，et al.Exploration and thinking on functional preservation after orthotopic neobladder construction［J］.Chinese Journal of Surgery，2022，60(11):969-972.
［9］汪鑫，朱猛，任立新，等.完全腹腔镜根治性膀胱切除+ρ形原位回肠新膀胱术的应用研究［J］.中华泌尿外科杂志，2019，40(10):747-752. WANG X，ZHU M，REN LX，et al.Clinical study of radical cystectomy under totally laparoscopy and p shape orthotopic ileal neobladder［J］.Chinese Journal of Urology，2019，40(10):747-752.
［10］王帅，祁小龙，刘锋，等.完全腔镜下根治性膀胱切除术及体内原位新膀胱重建术:10年回顾性分析［J］.中华泌尿外科杂志，2020，41(11):830-834. WANG S，QI XL，LIU F，et al.Retrospective analysis of laparoscopic radical cystectomy with complete intracorporealorthotopic neobladder reconstruction covering a peiord of ten years［J］.Chinese Journal of Urology，2020，41(11):830-834.
［11］PARRA RO，ANDRUS CH，JONES JP，et al.Laparoscopic cystectomy：initial report on a new treatment for the retained bladder［J］.J Urol，1992，148(4):1140-1144.
［12］KAOUK JH，AUTORINO R，KIM FJ，et al.Laparoendoscopic single-site surgery in urology：worldwide multi-institutional analysis of 1076 cases［J］.Eur Urol，2011，60(5):998-1005.
［13］SU J，ZHU Q，YUAN L，et al.Transumbilical laparoendoscopic single-site radical prostatectomy and cystectomy with the aid of a transurethral port：a feasibility study［J］.BJU Int，2018，121(1):111-118.
［14］胡嘏，叶章群，陈耀兵，等.经尿道膀胱肿瘤整块切除术标本病理学规范化检查的临床意义［J］.中华泌尿外科杂志，2019，40(7):492-497. HU G，YE ZQ，CHEN YB，et al.Clinical significance of standardized pathological examination of specimens for en bloc transurethral resection technique with Hybrid Knife to treat NMIBC［J］.Chinese Journal of Urology，2019，40(7):492-497.
［15］ABDALLAH A，ABDEL-HAKIEM M，EL-FEEL A.Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion：Technique，feasibility，and the 3-year follow-up［J］.Arab J Urol，2014，12(3):229-233.
［16］俞江，王锡智，罗斐埜，等.经尿道前列腺电切在合并神经源性因素的前列腺增生伴逼尿肌活动低下患者中的运用［J］.中国性科学，2019，28(2):20-22. YU J，WANG XZ，LUO FY，et al.Application of transurethral resection of the prostate in patients with benign prostatic hyperplasia and neurogenic detrusor underactivity［J］.Chinese Journal of Human Sexuality，2019，28(2):20-22.
［17］姚紫川，白松，姜云中，等.老年男性浸润性膀胱癌患者的诊治及预后分析［J］.现代肿瘤医学，2021，29(22):3968-3972. YAO ZC，BAI S，JIANG YZ，et al.Diagnosis and prognosis of muscle invasive bladder cancer in elderly male patients［J］.Modern Oncology，2021，29(22):3968-3972.
［18］汤亚箐，冉磊，唐澜.腹腔镜膀胱全切回肠膀胱术治疗浸润性膀胱癌疗效分析［J］.实用医院临床杂志，2019，25(4):101-104. TANG YJ，RAN L，TANG L.The curative effect of laparoscopic radical cystectomy and Bricker operation in the treatment of patients with invasive bladder cancer［J］.Practical Journal of Clinical Medicine，2019，25(4):101-104.

Memo

Memo:
江苏省卫生健康委科研项目(编号：ZD2021028)
Last Update: 2023-03-30