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Laparoscopic radical cystectomy with intracorporeal ileal conduit diversion: Modified techniques and long‐term outcomes
Author(s) -
Xu Yujie,
Pan Feng,
Liu Dong,
Yang Xiong,
Li Shuqiang,
Zhang Qijun,
Li Bing
Publication year - 2018
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12309
Subject(s) - medicine , cystectomy , urinary diversion , surgery , blood loss , stoma (medicine) , electrical conduit , hydronephrosis , urinary system , bladder cancer , cancer , mechanical engineering , engineering
Aim The aim of the present study was to assess the efficacy and long‐term outcomes of laparoscopic radical cystectomy (LRC) with ileal conduit urinary diversion for organ‐confined bladder carcinoma, undertaken intracorporeally using our modified techniques. Patients and Methods Seven male patients underwent LRC with intracorporeal ileal conduit diversion only using pure laparoscopic techniques. Results All procedures were completed without open conversion or intraoperative complications. The surgical margins of the specimens were negative in all patients. The mean duration of surgery was 7 h (range: 6–8.5), the mean blood loss was 420 mL (range: 330–750) and the mean postoperative hospital stay was 9 days (range: 7–15). At a mean follow up of 44 months (range: 36–49), one patient developed intestinal obstruction requiring an operation after 32 months. Another developed local oncological recurrence in the posterior urethra. One patient had bilateral inguinal lymphatic metastases, and another had hydronephrosis of the right kidney without symptoms. These complications and oncological recurrences were all found after 2 years. No patient has port site metastases and distant metastases to date. Conclusions LRC with ileal conduit diversion undertaken completely intracorporeally is a safe and feasible option for organ‐confined bladder carcinoma. Our modified techniques are helpful to simplify the procedure.