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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2018

Open Access 01-12-2018 | Research

Does previous abdominal surgery adversely affect perioperative and oncologic outcomes of laparoscopic radical cystectomy?

Authors: Xiaosong Wei, Jinjin Lu, Khurram Mutahir Siddiqui, Fan Li, Qianyuan Zhuang, Weimin Yang, Zhiquan Hu, Zhong Chen, Xiaodong Song, Shaogang Wang, Zhangqun Ye

Published in: World Journal of Surgical Oncology | Issue 1/2018

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Abstract

Background

Laparoscopic radical cystectomy (LRC) has been shown to have less estimated blood loss (EBL), transfusion rate, narcotic analgesic requirement, earlier return of bowel function, and shorter hospital stay. The aim of this study was to investigate the feasibility, peri-operative and oncologic outcomes of laparoscopic radical cystectomy (LRC) in patients with previous abdominal surgery (PAS).

Methods

We retrospectively reviewed 243 patients undergoing open radical cystectomy (ORC) or LRC with bilateral pelvic lymph node dissection and urinary diversion or cutaneous ureterostomy at a single center from January 2010 to December 2015. Demographic parameters, intra-operative variables, peri-operative records, pathologic outcomes, and complication rate were reviewed to assess the impact of PAS on peri-operative and oncologic outcomes.

Results

Patients in both ORC and LRC subgroups were homogeneous in terms of demography characteristics including age, gender, BMI, ASA score, and comorbidity. Estimated blood loss (EBL) was higher in patients with PAS undergoing ORC compared to those with no PAS (P = 0.008). However, there was no significant difference of EBL among patients undergoing LRC with or without PAS (P = 0.896). There was no statistical difference in peri-operative parameters and pathological outcomes. Patients with PAS undergoing ORC and ileal conduit had a higher vascular injury rate (P = 0.017). Comparing patients with PAS performed by LRC and ORC, the number of patients with the vascular injury was higher in ORC groups regardless of the type of diversion (ileal conduit, P = 0.001, cutaneous ureterostomy, P = 0.025). There is no significant difference in other complications.

Conclusion

The presence of adhesions from PAS is not a contraindication to LRC. Patients with PAS may benefit from LRC with lower estimated blood loss, fewer transfusion rates, and vascular injuries. Furthermore, the overall oncologic outcomes and complication rate are similar between LRC and ORC patients with PAS.
Literature
1.
2.
Zeng S, Zhang Z, Yu X, Song R, Wei R, Zhao J, et al. Laparoscopic versus open radical cystectomy for elderly patients over 75-year-old: a single center comparative analysis. PLoS One. 2014;9:e98950.CrossRefPubMedPubMedCentral
3.
Yasui T, Tozawa K, Ando R, Hamakawa T, Iwatsuki S, Taguchi K, et al. Laparoscopic versus open radical cystectomy for patients older than 75 years: a single-center comparative analysis. Asian Pac J Cancer Prev. 2015;16:6353–8.CrossRefPubMed
4.
Parra RO, Andrus CH, Jones JP, Boullier JA. Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol. 1992;148:1140–4.CrossRefPubMed
5.
Yuh BE, Ciccone J, Chandrasekhar R, Butt ZM, Wilding GE, Kim HL, et al. Impact of previous abdominal surgery on robot-assisted radical cystectomy. JSLS. 2009;13:398–405.PubMedPubMedCentral
6.
Pruthi RS, Wallen EM. Robotic-assisted laparoscopic radical cystoprostatectomy. Eur Urol. 2008;53:310–22.CrossRefPubMed
7.
Nazemi T, Galich A, Smith L, Balaji KC. Robotic urological surgery in patients with prior abdominal operations is not associated with increased complications. Int J Urol. 2006;13:248–51.CrossRefPubMed
8.
Pautler SE, Phillips JL, Walther MM. Assessment of risk for intra-abdominal adhesions at laparoscopy for urological tumors. J Urol. 2002;168:2391–4.CrossRefPubMed
9.
Khan MS, Gan C, Ahmed K, Ismail AF, Watkins J, Summers JA, et al. A single-centre early phase randomised controlled three-arm trial of open, robotic, and laparoscopic radical cystectomy (CORAL). Eur Urol. 2016;69:613–21.CrossRefPubMed
10.
Haber GP, Crouzet S, Gill IS. Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis. Eur Urol. 2008;54:54–62.CrossRefPubMed
11.
Albisinni S, Oderda M, Fossion L, Varca V, Rassweiler J, Cathelineau X, et al. The morbidity of laparoscopic radical cystectomy: analysis of postoperative complications in a multicenter cohort by the European Association of Urology (EAU)-section of Uro-technology. World J Urol. 2016;34:149–56.CrossRefPubMed
12.
Haber GP, Campbell SC, Colombo JJ, Fergany AF, Aron M, Kaouk J, et al. Perioperative outcomes with laparoscopic radical cystectomy: “pure laparoscopic” and “open-assisted laparoscopic” approaches. Urology. 2007;70:910–5.CrossRefPubMed
13.
Smith JA, Howards SS, Premiger GM. Hinman’s atlas of urologic surgery. 3rd ed. Philadelphia: Sanders Elsevier; 2012. p.501-512, 615-628.
14.
Rodriguez AR, Lockhart A, King J, Wiegand L, Carrion R, Ordorica R, et al. Cutaneous ureterostomy technique for adults and effects of ureteral stenting: an alternative to the ileal conduit. J Urol. 2011;186:1939–43.CrossRefPubMed
15.
Lin T, Fan X, Zhang C, Xu K, Liu H, Zhang J, et al. A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-upT Lin et al. Br J Cancer. 2014;110:842–9.CrossRefPubMedPubMedCentral
16.
Sogni F, Brausi M, Frea B, Martinengo C, Faggiano F, Tizzani A, et al. Morbidity and quality of life in elderly patients receiving ileal conduit or orthotopic neobladder after radical cystectomy for invasive bladder cancer. Urology. 2008;71:919–23.CrossRefPubMed
17.
Seifman BD, Dunn RL, Wolf JJ. Transperitoneal laparoscopy into the previously operated abdomen: effect on operative time, length of stay and complications. J Urol. 2003;169:36–40.CrossRefPubMed
18.
Parsons JK, Jarrett TJ, Chow GK, Kavoussi LR. The effect of previous abdominal surgery on urological laparoscopy. J Urol. 2002;168:2387–90.CrossRefPubMed
19.
Guillotreau J, Game X, Mouzin M, Doumerc N, Mallet R, Sallusto F, et al. Radical cystectomy for bladder cancer: morbidity of laparoscopic versus open surgery. J Urol. 2009;181:554–9.CrossRefPubMed
20.
Linder BJ, Frank I, Cheville JC, Matthew KT, Thompson RH, Tarrell RF, et al. The impact of perioperative blood transfusion on cancer recurrence and survival following radical cystectomy. Eur Urol. 2013;63:839–45.CrossRefPubMed
21.
Morgan TM, Barocas DA, Chang SS, Phillips SE, Salem S, Clark PE, et al. The relationship between perioperative blood transfusion and overall mortality in patients undergoing radical cystectomy for bladder cancer. Urol Oncol. 2013;31:871–7.CrossRefPubMed
22.
Hemal AK, Kolla SB, Wadhwa P, Dogra PN, Gupta NP. Laparoscopic radical cystectomy and extracorporeal urinary diversion: a single center experience of 48 cases with three years of follow-up. Urology. 2008;71:41–6.CrossRefPubMed
23.
Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol. 2013;189:474–9.CrossRefPubMed
24.
Albisinni S, Rassweiler J, Abbou CC, Cathelineau X, Chlosta P, Fossion L, et al. Long-term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro-technology. BJU Int. 2015;115:937–45.CrossRefPubMed
25.
Albisinni S, Limani K, Ingels L, Kwizera F, Bollens R, Hawaux E, et al. Long-term evaluation of oncologic and functional outcomes after laparoscopic open-assisted radical cystectomy: a matched-pair analysis. World J Urol. 2014;32:1455–61.CrossRefPubMed
26.
Springer C, Mohammed N, Alba S, Theil G, Altieri VM, Fornara P, et al. Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes. World J Urol. 2014;32:407–12.CrossRefPubMed
27.
Nunez-Mora C, Garcia MJ, Cabrera-Castillo PM, Garcia-Tello A, Gonzalez J, Angulo JC. Feasibility of lymphadenectomy in laparoscopic radical cystectomy. Urology. 2010;76:759–63.CrossRefPubMed
28.
Herr H, Lee C, Chang S, Lerner S. Standardization of radical cystectomy and pelvic lymph node dissection for bladder cancer: a collaborative group report. J Urol. 2004;171:1823–8. 1827-8CrossRefPubMed
29.
Stein JP, Penson DF, Cai J, Miranda G, Skinner EC, Dunn MA, et al. Radical cystectomy with extended lymphadenectomy: evaluating separate package versus en bloc submission for node positive bladder cancer. J Urol. 2007;177:876–81. discussion 881-2CrossRefPubMed
30.
Tang K, Li H, Xia D, Hu Z, Zhuang Q, Liu J, et al. Laparoscopic versus open radical cystectomy in bladder cancer: a systematic review and meta-analysis of comparative studies. PLoS One. 2014;9:e95667.CrossRefPubMedPubMedCentral
31.
Chade DC, Laudone VP, Bochner BH, Parra RO. Oncological outcomes after radical cystectomy for bladder cancer: open versus minimally invasive approaches. J Urol. 2010;183:862–9.CrossRefPubMed
32.
Dotan ZA, Kavanagh K, Yossepowitch O, Kaag M, Olgac S, Donat M, et al. Positive surgical margins in soft tissue following radical cystectomy for bladder cancer and cancer specific survival. J Urol. 2007;178:2308–12. 2313CrossRefPubMed
33.
Moschini M, Karnes RJ, Sharma V, Gandaglia G, Fossati N, Dell’Oglio P, et al. Patterns and prognostic significance of clinical recurrences after radical cystectomy for bladder cancer: a 20-year single center experience. Eur J Surg Oncol. 2016;42:735–43.CrossRefPubMed
Metadata
Title
Does previous abdominal surgery adversely affect perioperative and oncologic outcomes of laparoscopic radical cystectomy?
Authors
Xiaosong Wei
Jinjin Lu
Khurram Mutahir Siddiqui
Fan Li
Qianyuan Zhuang
Weimin Yang
Zhiquan Hu
Zhong Chen
Xiaodong Song
Shaogang Wang
Zhangqun Ye
Publication date
01-12-2018
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-018-1317-6

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