Laparoscopic radical cystoprostatectomy and in block urethrectomy in urethral cancer: initial experience in 2 cases.
We introduce laparoscopic radical cystoprostatectomy and in block urethrectomy as an option for the treatment of urethral cancer in men. Using a 5-port transperitoneal approach, a radical cystoprostatectomy is completed laparoscopically with bilateral iliac and pelvic lymphadenectomy. Urethrectomy and extraction of bladder and prostate is performed through a perineal incision. A segment of ileum is isolated and exteriorized to create an extracorporeal ileal conduit and restore ileo-ileal continuity by open standard technique. Bilateral stented uretero-ileal anastomosis is extracorporeally performed. Total operative time ranges from 4.5 to 4.8 hours. Laparoscopic radical cystoprostatectomy with perineal urethrectomy and an extracorporeally made ileal conduit is a feasible technique that can be reproduced. To our knowledge, this is the first report of laparoscopic radical surgery in the treatment of urethral cancer in men.
Castillo
Octavio A
OA
Section of Endourology and Laparoscopic Urology, Department of Urology, Clínica Santa Maria, Santiago de Chile, Chile. octaviocastillo@vtr.net
Pinto
Iván
I
Portalier
Paulo
P
Díaz
Manuel A
MA
Vitagliano
Gonzalo
G
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D014521:Urethra / Q000601:surgery*; D014523:Urethral Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*