Laparoscopic Radical Cystectomy

Fergany, Amr; Gill, Inderbir S.

doi:10.1016/j.ucl.2008.05.002

Cited by 20 publications

(7 citation statements)

References 37 publications

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“…In the past decade, minimally invasive approaches including robot-assisted approaches have emerged as a viable surgical option for many urological malignancies, with the promise of decreasing morbidity, shorter hospital stays, faster recovery and fewer narcotic analgesic requirements [6][7][8][9]. In recent years, several studies have documented the feasibility of minimally invasive approaches to carcinoma invading the bladder muscle [6,7,[9][10][11]. Comparisons of HRQoL in patients with bladder cancer have predominantly focused on comparing the differing types of urinary diversions (continent vs incontinent), with mixed results [12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life from a prospective randomised clinical trial of robot‐assisted laparoscopic vs open radical cystectomy

et al. 2014

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Objective To compare health‐related quality‐of‐life (HRQoL) outcomes for robot‐assisted laparoscopic radical cystectomy (RARC) with those of traditional open radical cystectomy (ORC) in a prospective randomised fashion. Patients and Methods This was a prospective randomised clinical trial evaluating the HRQoL for ORC vs RARC in consecutive patients from July 2009 to June 2011. We administered the Functional Assessment of Cancer Therapy–Vanderbilt Cystectomy Index questionnaire, validated to assess HRQoL, preoperatively and then at 3, 6, 9 and 12 months postoperatively. Scores for each domain and total scores were compared in terms of deviation from preoperative values for both the RARC and the ORC cohorts. Multivariate linear regression was used to assess the association between the type of radical cystectomy and HRQoL. Results At the time of the study, 47 patients had met the inclusion criteria, with 40 patients being randomised for analysis. The cohorts consisted of 20 patients undergoing ORC and 20 undergoing RARC, who were balanced with respect to baseline demographic and clinical features. Univariate analysis showed a return to baseline scores at 3 months postoperatively in all measured domains with no statistically significant difference among the various domains between the RARC and the ORC cohorts. Multivariate analysis showed no difference in HRQoL between the two approaches in any of the various domains, with the exception of a slightly higher physical well‐being score in the RARC group at 6 months. Conclusions There were no significant differences in the HRQoL outcomes between ORC and RARC, with a return of quality of life scores to baseline scores 3 months after radical cystectomy in both cohorts.

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Section: Introductionmentioning

confidence: 99%

Health‐related quality of life from a prospective randomised clinical trial of robot‐assisted laparoscopic vs open radical cystectomy

et al. 2014

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“…We successfully performed laparoscopic radical nephroureterectomy and cystectomy en bloc resection with lomboaortic and pelvic lymph node dissection in all 4 cases. Minimally invasive surgical techniques have been recommended to minimize the complications and to improve the recovery [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection

Petruț

Coman

Hârdo³

et al. 2020

Medicine and Pharmacy Reports

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Background & Aims: In patients with recurrent high grade or muscle invasive bladder cancer and concomitant upper urinary tract tumors or non-functional kidney can be performed laparoscopic radical cystectomy and nephroureterectomy with lomboaortic and pelvic lymph node dissection. We present our initial experience. Methods: Between 2018 and 2019, 4 patients underwent laparoscopic radical cystectomy and unilateral nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection. The nephroureterectomy was the first part of the surgery. After it, the radical cystectomy with lymphadenectomy was performed. All the specimes were removed en bloc in an endobag through a midline incision. Results: Patients demographic characteristics and perioperative outcomes were retrospectively collected and evaluated. All surgeries were completed laproscopically. There was no need of conversion to open surgery. The mean operative time was 286,25 min with minimal blood loss (260 ml). No major complications were reported. The mean follow-up period was 8,75 months. Conclusion: Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection can be safe and feasible in selected cases as an alternative approach to the open surgery, offering good oncological and functional results.

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“…The procedure of laparoscopic radical cystectomy has been reported in various series with minor modifications [5,9,19–21]. It is complicated and technically challenging requiring a detailed knowledge of pelvic anatomy and bladder cancer pathology.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic surgery is a precise operation that provides excellent visualization and decreased blood loss. As a result of the high incidence (15–25%) [5,6] of pelvic nodal metastasis, PLND is considered to be imperative for achieving therapeutic benefit, as well as for providing valuable diagnostic information [7], which is essential to prognosis. Standard PLND involves dissection and removal of nodes to the bifurcation of the common iliac artery.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic extended pelvic lymph node dissection during radical cystectomy: technique and clinical outcomes

Shao

Meng

et al. 2010

BJU International

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Study Type – Therapy (case series)  Level of Evidence 4 What’s known on the subject? and What does the study add? Pelvic lymph node dissection (PLND) is an obligatory step for radical cystectomy and it provides staging information and potential survival benefits. This study shows extended PLND with proximal boundary of inferior mesentery artery is safe and feasible under laparoscopy. More positive nodes can be retrieved compared to standard template. OBJECTIVE • To study the surgical techniques and clinical results of laparoscopic extended pelvic lymph node dissection during radical cystectomy. PATIENTS AND METHODS • From July 2007 to October 2009, 43 patients with bladder carcinoma received laparoscopic radical cystectomy with extended pelvic lymphadenectomy and urinary diversion. • Pelvic lymph node dissection (PLND) was first performed within extended template. • The lower part of aorta and vena cava were isolated from the bifurcation of common iliac artery to the level of the inferior mesenteric artery. • The standard template PLND was continued along the external iliac vessels, internal iliac vessels and obturator nerve. The bladder was then removed laparoscopically and urinary diversion was performed. RESULTS • All procedures were performed successfully and no open conversion occurred. The duration of the procedure for extended PLND was 90–185 min (mean 125 min) and total duration was 280–470 min (mean 329 min). • Intra‐operative blood loss was 200–1500 mL (mean 325 mL) and eight cases received transfusion. Pathological study identified transitional cell carcinoma and a negative margin in all cases. A range of 19–53 lymph nodes were dissected in the patients with a mean of 31.3. • In total, 17 positive nodes were confirmed in 11 cases. Postoperative complications included two cases of bowel obstruction, two cases of mild urine leakage and 17 cases of lymphatic leakage. CONCLUSIONS • Laparoscopic radical cystectomy with extended pelvic lymphadenectomy is indicated in selected patients with bladder cancer. • It is safe, minimally invasive and more lymph nodes can be retrieved with a higher success rate by extended pelvic lymphadenectomy.

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Laparoscopic Radical Cystectomy

Cited by 20 publications

References 37 publications

Health‐related quality of life from a prospective randomised clinical trial of robot‐assisted laparoscopic vs open radical cystectomy

Health‐related quality of life from a prospective randomised clinical trial of robot‐assisted laparoscopic vs open radical cystectomy

Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection

Laparoscopic extended pelvic lymph node dissection during radical cystectomy: technique and clinical outcomes

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