Pure intracorporeal laparoscopic radical cystectomy with orthotopic "u" shaped ileal neobladder

Abstract

Background: Radical cystectomy with pelvic lymph node dissection represents the standard treatment fo muscle-invasive, and high-risk non-muscle-invasive bladder cancers. Aim of this study was to report our case serie of 30 patients undergoing totally laparoscopic radical cystectomy (LRC) with reconstruction of an intracorporea orthotopic ileal neobladder. Intra-And perioperative results and the functional and oncological outcomes 9 month after operation are reported Methods: Between October 2010 and December 2012, 30 male patients underwent LRC with a pure laparoscopi orthotopic ileal "U"-shaped neobladder diversion. The men had a median age of 67 years, a median body mass inde of 22.3, and a mean ASA score of 2.2; they represented various clinical stages of disease Results: None of the patients required conversion to open surgery, and no perioperative mortalities were reported The median operating time was 365 min, and the median blood loss was 290 mL, with a transfusion rate of 26.6% All surgical margins were negative; 8 patients with nonorgan-confined disease or positive lymph nodes receive adjuvant chemotherapy. Early complications (within 30 days) occurred in 7 patients, and late complications occurred i 6 patients. The mean hospital stay was 9 days. At 9 months after surgery, the daytime continence rate was 83.3% an the nighttime continence rate was 73.3% Conclusions: Pure LRC with intracorporeal orthotopic ileal neobladder reconstruction may represent a viabl alternative to open radical cystectomy, with a significant reduction in patient morbidity. Future, large, randomize controlled trials with extensive follow-up are needed to confirm our encouraging results.