Surgical techniques for facilitating laparoscopic intracorporeal orthotopic neobladder: initial experience

Vol. 44 (x): 2018 April 4.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0505


ORIGINAL ARTICLE

Lianchao Jin 1,2, Mingshuai Wang 1, Feiya Yang 1, Yinong Niu 1, Nianzeng Xing 1
1 Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China; 2 Department of Urology, Peking University Shougang Hospital, Beijing, China

ABSTRACT

 

Purpose: To describe our technique and outcomes for laparoscopic intracorporeal ileal neobladder (ICNB) reconstruction.

Materials and Methods: From April 2014 to November 2016, 21 patients underwent laparoscopic ICNB at our tertiary referral centre. ICNB with bilateral isoperistaltic af­ferent limbs and several technique improvements were introduced. Demographics, clinical, and pathological data were collected. Perioperative, 1-year oncologic, 1-year Quality of life and 1-year functional outcomes were reported.

Results: ICNB was successfully performed in all 21 patients without open conversion and transfusion. Mean operative time was 345.6±66.9 min, including 106±22 min for LRC and PLND and 204±46.4 min for ICNB, respectively. Mean established blood loss was 192±146 mL. The overall incidence of 90-d complication was 33.3%, while major complication occurred in 4.8%. One-year daytime and night-time continence rates were 85.7% and 57.1%, respectively. One patient died from myocardial infarction six months postoperatively, and two patients had lung metastasis five months and six months respectively.

Conclusions: We described our experience of 3D LRC with a novel intracorporeal or­thotopic ileal neobladder, and the technique improvements facilitate the procedure. However, further studies are required to evaluate long-term outcomes of the intracor­poreal neobladder with bilateral isoperistaltic afferent limbs.

 Keywords: Laparoscopy; Quality of Life; Cystectomy

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