Laparoscopic radical cystectomy with intracorporeal ileal conduit: one center experience and clinical outcomes

Vol. 45 (3): 560-571, May – June, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0262


ORIGINAL ARTICLE

Jianye Li 1, Feiya Yang 1, Qingbao He 1, Mingshuai Wang 1, Nianzeng Xing 1
1 Department of Urology, “Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China

ABSTRACT

Purpose: To introduce our experience with intracorporeal ileal conduit and evaluate the safety and feasibility of this endoscopic urinary diversion.
Materials and Methods: Between March 2014 and July 2017, thirty-six consecutive patients underwent laparoscopic radical cystectomy with intracorporeal ileal conduit.
Patients’ demographic data, perioperative data, 90-days postoperative outcomes and complications were collected. This cohort were divided into two groups of 18 patients each by chronological order of the operations to facilitate comparison of clinical data.
Data were evaluated using the students’ T test, Mann-Whitney test and Fisher’s Exact test.
Results: All surgeries were completed successfully with no conversion. Median total operating time and median intracorporeal urinary diversion time were 304 and 105 minutes, respectively. Median estimated blood loss was 200 mL, and median lymph node yield was 21. Twenty-six Clavien grade < 3 complications occurred within 30-days and 9 occurred within 30-90 days. Five Clavien grade 3-5 complications occurred within 30 days. No statistically signifi cant differences were found between the two groups except for intracorporeal urinary diversion time. At median follow-up of 17.5 (range 3-42) months, 6 patients experienced tumor recurrence/metastasis and 4 of these patients died.
Conclusions: Intracorporeal ileal conduit following laparoscopic radical cystectomy is safe, feasible and reproducible. With the accumulation of experience, the operation time can be controlled at a satisfactory level.

Keywords: Laparoscopy; Urinary Diversion; Cystectomy

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