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Laparoscopic radical cystectomy with orthotopic ileal neobladder in the treatment of invasive bladder cancer

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Author:
No author available
Journal Title:
Chinese Journal of Oncology
Issue:
10
DOI:
10.3760/cma.j.issn.0253-3766.2012.10.016
Key Word:
腹腔镜检查;膀胱肿瘤;尿动力学;尿流改道术;Laparoscopy;Urinary bladder neoplasms;Urodynamics;Urinary diversion

Abstract: Objective To study the technique and outcomes of laparoscopic radical cystectomy (LRC) and evaluate the efficacy of the urinary reservoir constructed with ileum in patients with invasive bladder cancer.Methods From 2005-2010,A total of 11 patients with bladder.cancer were enrolled in this study.Laparoscopy was performed with 5 trocars.Urodynamic examination was performed,the function of upper urinary tract was tested,and complications were evaluated in all the eleven cases.Results The mean operation time was 420 minutes (ranged 350 to 490 min) and mean blood loss was 410 ml (ranged 300 to 700 ml).Ten of the 11 patients had complete continence,and one case had incontinence.The average flow rate was 11.5 ml/s.The first pressure of the reservoir was 29 cm H2O,and the maximum pressure was 36 cm H2O.The average capacity was 162 ml and 410 ml,respectively.The outlet pressure was 49 cm H2O.The volume of residual urine was 0-35 ml.No evidence of ureteral reflux was noted.Conclusions Laparoscopic radical cystectomy is a promising method for the treatment of bladder cancer.Orthotopic ileal neobladder is considered as an ideal form of urinary diversion characterized with low pressure,larger capacity and continence.

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