Skip to main content
Top
Published in: BMC Urology 1/2018

Open Access 01-12-2018 | Research article

Laparoscopic radical cystectomy with pelvic re-peritonealization: the technique and initial clinical outcomes

Authors: Qiang Cao, Pengchao Li, Xiao Yang, Jian Qian, Zengjun Wang, Qiang Lu, Min Gu

Published in: BMC Urology | Issue 1/2018

Login to get access

Abstract

Background

Delayed bowel function recovery and postoperative ileus are relatively serious complications of laparoscopic radical cystectomy (LRC). Our study aimed to determine whether performing pelvic re-peritonealization reduces the incidence of these complications.

Methods

Clinical data of 78 patients who had undergone LRC with pelvic re-peritonealization from August 2015 to December 2017 were retrospectively collected and compared with those of 92 patients who had undergone LRC alone between January 2013 and July 2015 in our institution. Differences in duration of surgery, estimated blood loss, time to recovery of bowel function, the complications of intestinal and blood vessel injury, and incidence of postoperative ileus between the two groups were analyzed.

Results

Baseline characteristics such as age, sex and BMI were balanced between the two groups. There were no significant differences in duration of surgery (P = 0.072), estimated blood loss (P = 0.717), or incidence of intestinal obstruction (P = 0.225) between the two groups. Interestingly, patients who had undergone pelvic re-peritonealization recovered bowel function more rapidly than those had not (2.79 d vs. 3.72 d, P = 0.001). Additionally, hospitalization stay was significantly shorter for patients with re-peritonealization than for those without (5.46 d vs. 6.68 d, P = 0.029).

Conclusions

Compared with LRC alone, LRC with pelvic re-peritonealization as described in the present study had comparable perioperative complications, but was associated with more rapid gastrointestinal recovery and shorter hospitalization stay.
Literature
1.
go back to reference Zhang M, Li H, Zou D, Gao J. Ruguo key genes and tumor driving factors identification of bladder cancer based on the RNA-seq profile. OncoTargets and therapy. 2016;9:2717–23.PubMedPubMedCentral Zhang M, Li H, Zou D, Gao J. Ruguo key genes and tumor driving factors identification of bladder cancer based on the RNA-seq profile. OncoTargets and therapy. 2016;9:2717–23.PubMedPubMedCentral
2.
go back to reference Ng CK, Kauffman EC, Lee MM, Otto BJ, Portnoff A, Ehrlich JR, Schwartz MJ, Wang GJ, Scherr DS. A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol. 2010;57(2):274–81.CrossRef Ng CK, Kauffman EC, Lee MM, Otto BJ, Portnoff A, Ehrlich JR, Schwartz MJ, Wang GJ, Scherr DS. A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol. 2010;57(2):274–81.CrossRef
3.
go back to reference Hautmann RE. Urinary diversion: ileal conduit to neobladder. J Urol. 2003;169(3):834–42.CrossRef Hautmann RE. Urinary diversion: ileal conduit to neobladder. J Urol. 2003;169(3):834–42.CrossRef
4.
go back to reference Tang K, Xia D, Li H, Guan W, Guo X, Hu Z, Ma X, Zhang X, Xu H, Ye Z. Robotic vs. open radical cystectomy in bladder cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2014;40(11):1399–411.CrossRef Tang K, Xia D, Li H, Guan W, Guo X, Hu Z, Ma X, Zhang X, Xu H, Ye Z. Robotic vs. open radical cystectomy in bladder cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2014;40(11):1399–411.CrossRef
5.
go back to reference Mansur RB, Rizzo LB, Santos CM, Asevedo E, Cunha GR, Noto MN, Pedrini M, Zeni M, Cordeiro Q, McIntyre RS, et al. Impaired glucose metabolism moderates the course of illness in bipolar disorder. J Affect Disord. 2016;195:57–62.CrossRef Mansur RB, Rizzo LB, Santos CM, Asevedo E, Cunha GR, Noto MN, Pedrini M, Zeni M, Cordeiro Q, McIntyre RS, et al. Impaired glucose metabolism moderates the course of illness in bipolar disorder. J Affect Disord. 2016;195:57–62.CrossRef
6.
go back to reference Khan MS, Elhage O, Challacombe B, Rimington P, Murphy D, Dasgupta P. Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system. Urology. 2011;77(2):357–62.CrossRef Khan MS, Elhage O, Challacombe B, Rimington P, Murphy D, Dasgupta P. Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system. Urology. 2011;77(2):357–62.CrossRef
7.
go back to reference Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19(3):666–75.CrossRef Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19(3):666–75.CrossRef
8.
go back to reference Studer UE, Burkhard FC, Schumacher M, Kessler TM, Thoeny H, Fleischmann A, Thalmann GN. Twenty years experience with an ileal orthotopic low pressure bladder substitute--lessons to be learned. J Urol. 2006;176(1):161–6.CrossRef Studer UE, Burkhard FC, Schumacher M, Kessler TM, Thoeny H, Fleischmann A, Thalmann GN. Twenty years experience with an ileal orthotopic low pressure bladder substitute--lessons to be learned. J Urol. 2006;176(1):161–6.CrossRef
9.
go back to reference Djaladat H, Daneshmand S. Gastrointestinal complications in patients who undergo radical cystectomy with enhanced recovery protocol. Current urology reports. 2016;17(7):50.CrossRef Djaladat H, Daneshmand S. Gastrointestinal complications in patients who undergo radical cystectomy with enhanced recovery protocol. Current urology reports. 2016;17(7):50.CrossRef
10.
go back to reference Maffezzini M, Campodonico F, Canepa G, Gerbi G, Parodi D. Current perioperative management of radical cystectomy with intestinal urinary reconstruction for muscle-invasive bladder cancer and reduction of the incidence of postoperative ileus. Surg Oncol. 2008;17(1):41–8.CrossRef Maffezzini M, Campodonico F, Canepa G, Gerbi G, Parodi D. Current perioperative management of radical cystectomy with intestinal urinary reconstruction for muscle-invasive bladder cancer and reduction of the incidence of postoperative ileus. Surg Oncol. 2008;17(1):41–8.CrossRef
11.
go back to reference Shao P, Meng X, Li J, Lv Q, Zhang W, Xu Z, Yin C. Laparoscopic extended pelvic lymph node dissection during radical cystectomy: technique and clinical outcomes. BJU Int. 2011;108(1):124–8.CrossRef Shao P, Meng X, Li J, Lv Q, Zhang W, Xu Z, Yin C. Laparoscopic extended pelvic lymph node dissection during radical cystectomy: technique and clinical outcomes. BJU Int. 2011;108(1):124–8.CrossRef
12.
go back to reference Rivas JG, Sergio Alonso Y, JCL G, Orejón RU, Doslada PU, Sebastián JD, Gómez ÁT, de la Peña Barthel JJ. Early recovery protocol in patients undergoing laparoscopic radical cystectomy. Urological Science. 2015;28(1):2–5.CrossRef Rivas JG, Sergio Alonso Y, JCL G, Orejón RU, Doslada PU, Sebastián JD, Gómez ÁT, de la Peña Barthel JJ. Early recovery protocol in patients undergoing laparoscopic radical cystectomy. Urological Science. 2015;28(1):2–5.CrossRef
13.
go back to reference Kalff JC, Carlos TM, Schraut WH, Billiar TR, Simmons RL, Bauer AJ. Surgically induced leukocytic infiltrates within the rat intestinal muscularis mediate postoperative ileus. Gastroenterology. 1999;117(2):378–87.CrossRef Kalff JC, Carlos TM, Schraut WH, Billiar TR, Simmons RL, Bauer AJ. Surgically induced leukocytic infiltrates within the rat intestinal muscularis mediate postoperative ileus. Gastroenterology. 1999;117(2):378–87.CrossRef
14.
go back to reference Gill IS, Fergany A, Klein EA, Kaouk JH, Sung GT, Meraney AM, Savage SJ, Ulchaker JC, Novick AC. Laparoscopic radical cystoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases. Urology. 2000;56(1):26–9 discussion 29-30.CrossRef Gill IS, Fergany A, Klein EA, Kaouk JH, Sung GT, Meraney AM, Savage SJ, Ulchaker JC, Novick AC. Laparoscopic radical cystoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases. Urology. 2000;56(1):26–9 discussion 29-30.CrossRef
15.
go back to reference Murphy DG, Challacombe BJ, Elhage O, O'Brien TS, Rimington P, Khan MS, Dasgupta P. Robotic-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: initial experience. Eur Urol. 2008;54(3):570–80.CrossRef Murphy DG, Challacombe BJ, Elhage O, O'Brien TS, Rimington P, Khan MS, Dasgupta P. Robotic-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: initial experience. Eur Urol. 2008;54(3):570–80.CrossRef
16.
go back to reference Gause CD, Casamassima MG, Yang J, Hsiung G, Rhee D, Salazar JH, Papandria D, Pryor HI 2nd, Stewart D, Lukish J, et al. Laparoscopic versus open inguinal hernia repair in children </=3: a randomized controlled trial. Pediatr Surg Int. 2017;33(3):367–76.CrossRef Gause CD, Casamassima MG, Yang J, Hsiung G, Rhee D, Salazar JH, Papandria D, Pryor HI 2nd, Stewart D, Lukish J, et al. Laparoscopic versus open inguinal hernia repair in children </=3: a randomized controlled trial. Pediatr Surg Int. 2017;33(3):367–76.CrossRef
Metadata
Title
Laparoscopic radical cystectomy with pelvic re-peritonealization: the technique and initial clinical outcomes
Authors
Qiang Cao
Pengchao Li
Xiao Yang
Jian Qian
Zengjun Wang
Qiang Lu
Min Gu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2018
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-018-0424-6

Other articles of this Issue 1/2018

BMC Urology 1/2018 Go to the issue