MP38-19 READAPTATION OF THE PERITONEUM FOLLOWING EXTENDED PELVIC LYMPH NODE DISSECTION (PLND) AND CYSTECTOMY HAS BENEFICIAL IMPACT ON BOWEL FUNCTION IN THE LONG TERM WITHOUT COMPROMISING ONCOLOGICAL RADICALITY.

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2016MP38-19 READAPTATION OF THE PERITONEUM FOLLOWING EXTENDED PELVIC LYMPH NODE DISSECTION (PLND) AND CYSTECTOMY HAS BENEFICIAL IMPACT ON BOWEL FUNCTION IN THE LONG TERM WITHOUT COMPROMISING ONCOLOGICAL RADICALITY. Bernhard Kiss, Mihai Dorin Vartolomei, Alvaro Vidal Faune, George N. Thalmann, and Beat Roth Bernhard KissBernhard Kiss More articles by this author , Mihai Dorin VartolomeiMihai Dorin Vartolomei More articles by this author , Alvaro Vidal FauneAlvaro Vidal Faune More articles by this author , George N. ThalmannGeorge N. Thalmann More articles by this author , and Beat RothBeat Roth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.123AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Decrease in postoperative pain and earlier recovery of bowel function were achieved in patients after readaptation of the peritoneum following extended PLND and cystectomy. The aim of our study was to evaluate oncological outcomes and bowel function in the long term. METHODS Randomized, single center, single blinded, two-arm trial of 200 consecutive cystectomy patients who underwent PLND and cystectomy for bladder cancer <cT4, cN0, cM0 between April 2006 and September 2009. Postoperative follow-up was performed after 3, 6, 12 and 24 months, and annually thereafter. Bowel function was evaluated using questionnaires. Local recurrences and distal metastases were evaluated using computed tomography and bone scan 6, 12, and 24 months following surgery, and if clinically indicated. RESULTS Patients were randomized into two groups: group A with readaptation of the peritoneum and group B without readaptation of the peritoneum. (Table) Median follow-up was 59 months (range: 3 - 100). Five and 7 patients were lost to follow-up in group A and group B, respectively. There was no significant difference between the two groups in terms of rate of local (pelvic) recurrence (6/95 (6%) in group A; 6/93 (6%) in group B; p = 0.94), rate of distant metastases (20/95 (21%) in group A; 23/93 (25%) in group B; p = 0.67), tumour specific (p = 0.62) and overall survival (p = 0.51). Bowel function remained significantly better after readaptation of the peritoneum at 3 (p<0.001), 6 (p<0.001), 12 (p<0.02) and 24 months (p<0.03). Also, there was significantly less postoperative abdominal pain seen after readaptation of the peritoneum at 3, 6, 12 and 24 months (p < 0.001). CONCLUSIONS Readaptation of the dorsolateral peritoneal layer after extended PLND and cystectomy is an oncologically safe technique resulting in better bowel function and less abdominal pain in the long term. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e540 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Bernhard Kiss More articles by this author Mihai Dorin Vartolomei More articles by this author Alvaro Vidal Faune More articles by this author George N. Thalmann More articles by this author Beat Roth More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...