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01-04-2014 | Original Article

Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes

Authors: Christopher Springer, Nasreldin Mohammed, Stefano Alba, Gerit Theil, Vincenzo Maria Altieri, Paolo Fornara, Francesco Greco

Published in: World Journal of Urology | Issue 2/2014

Abstract

Objectives

To report the surgical outcomes of laparoscopic radical cystectomy (LRC) with extracorporeal orthotopic ileal neobladder (OIN) in patients with muscle-invasive urothelial carcinoma of the bladder (UCB).

Materials and methods

Between October 2009 and December 2011, 37 patients with muscle-invasive UCB underwent a LRC with OIN. Indications included (a) muscle-invasive UCB T2–4a, N0–Nx, M0; (b) high-risk and recurrent non-muscle-invasive tumors; (c) T1G3 plus CIS; and (d) extensive non-muscle-invasive disease that could not be controlled by transurethral resection and intravesical therapy. Demographic data, perioperative, and postoperative variables were recorded and analyzed.

Results

The median operating time was 330 min, with a median estimated blood loss of 410 ml. Median length of stay was 12 days, and the mean length of the skin incision to extract the specimen and for the configuration of the neobladder was 7 ± 1 cm. The complication rate was 21.6 % (Clavien II). No Clavien III–V complications were reported. Daytime and nocturnal continence were preserved in 95 and 78 %, respectively. No local recurrence or port site metastasis occurred. Median time to disease recurrence was 14 months (IQR 9–24), and 1-year cancer-specific survival was 91.9 %.

Conclusions

Laparoscopic radical cystectomy with extracorporeal ileal neobladder is a challenging procedure but technically feasible, allowing low morbidity and oncological safety. Long-term oncological results are required to definitely recognize this procedure as a standard treatment for bladder cancer.

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Title: Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes
Authors: Christopher Springer
Nasreldin Mohammed
Stefano Alba
Gerit Theil
Vincenzo Maria Altieri
Paolo Fornara
Francesco Greco
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 2/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1122-3

At a glance: The STEP trials

Springer Medicine

Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes

Abstract

Objectives

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

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