Laparoscopic radical cystectomy with ileal neobladder and rectum pouch: the initial experience of 28 cases in China.
BACKGROUND
We presented the technique and outcomes of laparoscopic radical cystectomy performed in 28 patients with bladder cancer to evaluate its clinical efficacy and feasibility.


METHODS
Among the 28 patients, aged from 58 to 73 years (mean 68.5 years), 26 were transitional cell carcinoma grads II - III and 2 squamous carcinoma. Laparoscopic radical cystectomy plus bladder reconstruction was performed in all cases, among them 15 with ileum, 10 with rectum pouch, and 3 with ureterostomy. The operating time, the blood loss, the intestine function and the complications were observed.


RESULTS
All procedures were successful. The operating times were 7 - 10 hours, the blood loss was 400 - 1500 ml (mean 850 ml), the intestine function recovered at 72 hours after operation, and all ureteral catheters were removed at 2 weeks after surgery. The results of intravenous urography were normal at 3-month, 1-year, and 2-year follow-up after surgery.


CONCLUSIONS
Laparoscopic radical cystectomy for invasive bladder cancer is safe and efficient, with good operating field, reliable hemostasis, mini-invasion, less celiac complications, and rapid recovery. This surgery is worth being extended.
Xia
Guo-wei
GW
Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.
Ding
Qiang
Q
Xu
Ke
K
Zhang
Yuan-fang
YF
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods; D016476:Urinary Reservoirs, Continent