Perioperative Outcomes with Laparoscopic Radical Cystectomy: “Pure Laparoscopic” and “Open-Assisted Laparoscopic” Approaches

Haber, Georges Pascal; Campbell, Steven C.; Colombo, José R.; Fergany, Amr; Aron, Monish; Kaouk, Jihad; Gill, Inderbir S.

doi:10.1016/j.urology.2007.07.012

Cited by 116 publications

(75 citation statements)

References 17 publications

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“…In this series, all patients primarily underwent extracorporeal ileal conduit urinary diversion because they were all elderly and at high surgical risk with multiple medical and that the open-assisted laparoscopic approach for urinary diversion portion of the procedure is technically with the pure laparoscopic approach during LRC (18).…”

Section: Commentsmentioning

confidence: 99%

Simultaneous laparoscopic nephroureterectomy and cystectomy: a preliminary report

et al. 2008

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Purpose: Patients with muscle-invasive bladder cancer and concomitant upper urinary tract tumors may be candidates for simultaneous cystectomy and nephroureterectomy. Other clinical conditions such as dialysis-dependent end-stage renal disease and non-functioning kidney are also indications for simultaneous removal of the bladder and kidney. In the present study, we report our laparoscopic experience with simultaneous laparoscopic radical cystectomy (LRC) and nephroureterectomy. Materials and Methods: Between August 2000 and June 2007, 8 patients underwent simultaneous laparoscopic radical nephroureterectomy (LNU) (unilateral-6, bilateral-2) and radical cystectomy at our institution. Demographic data, pathologic features, surgical technique and outcomes were retrospectively analyzed. Results: The laparoscopic approach was technically successful in all 8 cases (7 males and 1 female) without the need for open conversion. Median total operative time, including LNU, LRC, pelvic lymphadenectomy and urinary diversion, was 9 hours (range 8-12). Median estimated blood loss and hospital stay were 755 mL (range 300-2000) and 7.5 days (range 4-90), respectively. There were no intraoperative complications but only 1 major and 2 minor postoperative complications.(range 1-45). Conclusions: Laparoscopic nephroureterectomy with concomitant cystectomy is technically feasible. Greater number of

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Section: Commentsmentioning

confidence: 99%

Simultaneous laparoscopic nephroureterectomy and cystectomy: a preliminary report

et al. 2008

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“…We think this trend will continue. Haber et al [16] compared the complication rate in bladder cancer patients treated with pure (total procedure performed laparoscopically) LRC and LRC with minilaparotomy (hand assisted) for urinary diversion. They found 29% of complications in a cohort treated with pure LRC.…”

Section: Discussionmentioning

confidence: 99%

“…Recent advances, including laparoscopic radical cystectomy, have led to decreased morbidity. Despite these observations, LRC remains a complex procedure with potential both short-and long-term complications [7,10,14,16,19,20] . Multivariate analysis showed that length of surgery greater than 4 h and preoperative serum creatinine greater than 1.5 mg/dl were independent risk factors for perioperative complications after LRC [20] .…”

Section: Discussionmentioning

confidence: 99%

Is Pure Laparoscopic Radical Cystectomy Still an Attractive Solution for the Treatment of Muscle-Invasive Bladder Cancer?

Chłosta¹,

Drewa²,

Dobruch³

et al. 2010

Urol Int

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Objective: The aim of this study is to report our experience with laparoscopic radical cystectomy (LRC), evaluating the technique and perioperative and pathological outcomes. Methods: 47 LRCs were performed due to muscle-invasive bladder cancer. Conduits were performed in 23 patients and neobladders in 23 (one bi-intestinal). One ureterocutaneostomy was created. Results: In 43 patients LRC was performed with minilaparotomy for urinary diversion. The mean operation time was 290 min. Four operations were converted. Complications included sigmoid colon injury, urinary leak, lymphatic leak, short-term paralytic ileus, and heart attack. Mean blood loss was 220 ml. Hospitalization time was 6 days. Tumor stage was pT2b, pT3a, pT3b, and pT4a in 28, 13, 5, and 1 patient, respectively. No positive margins were found. The mean number of lymph nodules was 17, while in the last 25 procedures it was 21. 17% of patients had tumor in the lymph nodes. The mean follow-up was 10 months. Local recurrence and dissemination was observed in 2%. Continence in patients receiving neobladder was fully satisfactory. Conclusions: More complications are related to neobladder than to ileac conduit. LRC with minilaparotomy seems to be an attractive treatment option for patients with muscle-invasive bladder cancer. Radical cystectomy performed intracorporeally could be reserved for ‘robot-assisted’ operations.

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“…Although the intracorporeal technique is aesthetically superior, particularly in women, where a vaginal specimen extraction can be obtained, resulting in a truly 'incision-free' cystectomy, the intracorporeal technique results in a significantly longer operation and has been associated with a higher rate of bowelrelated complications in initial series [16]. Although intracorporeal bowel surgery is becoming more frequently reported, particularly with robotic assistance, most surgeons prefer to construct the urinary diversion through a mini-laparotomy that is also used for extracting the surgical specimen.…”

Section: Urinary Diversionmentioning

confidence: 99%

Laparoscopic Radical Cystectomy

Fergany

Gill

2008

Urologic Clinics of North America

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Perioperative Outcomes with Laparoscopic Radical Cystectomy: “Pure Laparoscopic” and “Open-Assisted Laparoscopic” Approaches

Cited by 116 publications

References 17 publications

Simultaneous laparoscopic nephroureterectomy and cystectomy: a preliminary report

Simultaneous laparoscopic nephroureterectomy and cystectomy: a preliminary report

Is Pure Laparoscopic Radical Cystectomy Still an Attractive Solution for the Treatment of Muscle-Invasive Bladder Cancer?

Laparoscopic Radical Cystectomy

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