Complications and Perioperative Managements after Extraperitoneal Laparoscopic Radical Cystectomy and Ileal Orthotopic Neobladder: Our Initial Experience

Abstract

Objective With the increasing of extraperitoneal laparoscopic radical cystectomy (ELRC) and ileal orthotopic neobladder (ION), we described perioperative management, complications and management of postoperative complications for patients with ELRC and ION. Methods We retrospectively collected perioperative managements, complications and management of postoperative complications for patients after ELRC and ION from January 2020 to December 2023 in our center. Results Totally 81 patients with bladder tumor underwent ELRC and ION. 48patients suffered from postoperative complications. According to Clavien-Dindo class, 21 patients were identified as 1, 18 patients were identified as 2, and 7 patients were identified as 3. Only 2 patient was identified as 4. The mean follow-up was 31 ± 17.64 months. Overall survival was 97.53%. Recurrence-free survival was 92.59%. The main short-term complications were infection(23.46%), ileus(3.70%), leakage of urine(17.28%), lymph fistula(8.64%), anemia and hypoproteinemia(9.88%). Medium- and long-term complications were Chronic hydronephrosis(8.64%), Anastomotic stoma stricture of ureter (2.47%), Anastomotic stoma stricture of urethra(6.17%), stone(4.94%) and incontinence (9.88%). Conclusions Most of complications after ELRC and ION were informidable and solvable. Invasive approaches need to be considered and performed by experienced urologists.