The evaluation of the standardized design for laparoscopic cystectomy with orthotopic ileal neobladder

Abstract

Objective To investigate the safety and efficacy of standardized design for laparoscopic cystectomy with orthotopic ileal neobladder (LRC-OIN) for bladder cancer. Methods From Jul. 2014 to Oct. 2016, 34 patients with bladder cancer underwent standardized design LRC-OIN at our hospital and were enrolled in this study. The patients′ information, postoperative complications, pathologic characteristics, and survival data were collected and analysed. Results The average age of patients was 65.5 years (48-79 years). All patients were successfully operated without conversion to open surgery or adding trocars. The average operation time was 352 min (295-436 min), and the average bleeding volume was 112 ml (50-350 ml). The postoperative complications within 30 days, Clavien Ⅰ-Ⅱ12 were cases, Clavien Ⅲ-V 4 were cases. The mean of lymph node dissection was 14.5, and lymph node positive percentage was 16.7%. Postoperative pathology showed 3 cases were T1N0G3, 6 cases were T2aN0, 11 cases were T2bN0, 2 cases were T2bN1, 5 cases were T3aN0, 4 cases were T3aN1, 3 cases were T3bN0. All surgical margins were negative. Patients were satisfied with postoperative appearance. The median follow-up time was 24 months (2-48 months), 1 patient with postoperative intestinal obstruction was transferred to the Department of general surgery. All patients were alive. No local recurrence cases. 2 patients were underwent chemotherapy who were found distant metastasis at 12 and 15 months after surgery. Patients could achieve good continence during the day 6 months after operation, and 6 patients could not control urine at night. Conclusions Standardized design laparoscopic radical cystectomy with orthotopic ileal neobladder was technically feasible. Our data has shown the recent oncological outcome is well. The outcome may need a long-term large sample study to further elaborate. Key words: Bladder cancer; Laparoscopic surgery; Radical cystectomy-orthotopic ileal neobladde