Our first experience of laparoscopic cystectomy in the treatment of muscle invasive bladder cancer
https://doi.org/10.17650/1726-9776-2008-4-1-29-33
Abstract
Objective. Radical cystectomy is the gold standart in the treatment of muscle invasive bladder cancer. We report our initial experience with laparoscopic cystectomy with low-invasive laparotomy and formation of the neobladder by Studer. Results were compared with traditional cystectomy.
Materials and Methods. Since 2003 five patients (1) underwent a laparoscopic cystectomy at our hospital. All patients were male (with a mean age of 57(51—67) and had T2N0M0 stage bladder cancer (G1-2). The procedure consists of two parts: 1 — laparoscopic mobilization of the bladder, ureters, prostate glang and vesicles; 2 — low invasive laparotomy (length 4—5 cm) with special tools and illumination, extraction of the bladder and formation of the neobladder by Studer. Traditional cystectomy (2) with orthotopic neobladder has been applied to 49 patients. There were 45 males and 4 females. Mean age was 62,7 (39—74).
Results. In the first group (1) the mean time of procedure was 505 (430—570) min. Blood loss was between 150—300 ml. There were not serious postoperative complications. Function of intestines was restored in 4 days. The ureteral drainages were removed on 14 day, urethral catheters — on 16 postoperative day. Urodynamic studies after procedure revealed Q max — 18,4 (17—19) ml/sec. In the second group (2) the mean time of procedure was 306 (246—350) min. Blood loss was between 615 (300—1200) ml. Function of intestines was restored in 7 days.
Conclusions. Our initial results indicate, that a laparoscopic cystectomy is an effective surgical method, which is less invasive and deleterious in comparison with open cystectomy.
About the Authors
V. N. Dubrovin
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
A. V. Tabakov
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
G. A. Melnik
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
R. R. Shakirov
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
O. V. Mihaylovskiy
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
A. V. Yegoshin
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
K. A. Kudryashov
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
V. I. Sharov
Republican clinical hospital, urology department
Russian Federation
Yoshkar-Ola
Russian Federation
Yoshkar-Ola
References
1. Матвеев Б.П., Фигурин К.М., Карякин О.Б. Рак мочевого пузыря. М., Вердана; 2001.
2. Харченко В.П., Каприн А.Д., Ставицкий Р.В. и др. Интервенционная радиология: рак мочевого пузыря. М.; 2002.
3. Коган М.И., Перепечай В.А. Современная диагностика и хирургия рака мочевого пузыря. Ростов-на-Дону; 2002.
4. Cempbell's Urology. 8th ed. P.C.Walsh, A.B. Retik, E.D. Vaughan and A.J. Wein (eds).
5. Hautmann R.E., De Peticoni R., Gottfried H.W. et al. The ileal neobladder: complication and functional results in 363 patients after 11 years of follow up. J Urol 1999;161(2):422—8.
6. Simonato A., Gill I.S., Desai M. et al. Laparoscopic radical cystoprostatectomy: our experience in a concenutive series of 10 patients with 3 years follow-up. Eur Urol 2005;47(6):785—90.
7. Guazzoni G., Cestari A., Colombo R. et al. Laparoscopic nerve- and seminalsparing cystectomy with ortotopic ileal neobladder: the first three cases. Eur Urol 2003;44(5):576—2.
8. Massoud W., Rebai N., Peyrat L. et al. Laparoscopic cystectomy and neobladder formation in women. Urology 2007;70(3):183.
9. Menon M., Hemal A.K., Tewari A. et al. Nerve-sparing robot-assisted radical cystoprostatectomy and urinary divertion. BJU Int 2003;92(3):232—6.
10. Sanchez de Badajoz E., Gallego Perales J.L., Reche Rosado A. et al. Laparoscopic cystectomy and ileal conduit: case report. J Endourol 1995;9:59—62.
11. Puppo P., Peraccino M., Picciotti G. et al. Laparoscopically assisted transvaginal cystectomy. Eur Urol 1995;27:80.
12. Gill I.S., Fergani A., Klein E.A. et al. Laparoscopic radical cystprostatectomy with ileal conduit performed completely intracorporeally: the initial two cases. Urology 2000;56:26.
13. Rimington P. Laparoscopic cystectomy. BJU Int 2004;4:460.
14. Федоров И.В., Федоров И.С., Зыятдинов К.Ш. Оперативная лапароскопия М., Триада-Х; 2004.
15. Stein J.P., Quek M.L., Skinner D.G. Lymphadeectomy for invasive bladder cancer: I. historical perspective and contemporary rationale. BJU Int 2006;97:227—31.
16. Lebret T., Herve J.M., Jonneaue L. et al. After cystectomy, is it justified to perform a bladder replacement for patients with lymph node positive bladder cancer? Eur Urol 2002;42:344—9.
Review
For citations:
Dubrovin V.N., Tabakov A.V., Melnik G.A., Shakirov R.R., Mihaylovskiy O.V., Yegoshin A.V., Kudryashov K.A., Sharov V.I. Our first experience of laparoscopic cystectomy in the treatment of muscle invasive bladder cancer. Cancer Urology. 2008;4(1):29-33. (In Russ.) https://doi.org/10.17650/1726-9776-2008-4-1-29-33
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