[Laparoscopic radical cystectomy with orthotopic ileal neobladder: report of 108 cases].
OBJECTIVE
To analyze the effects, complication, and outcome of laparoscopic radical cystectomy.


METHODS
108 patients with bladder cancer, 96 males and 12 females, aged 61 (36 - 81) underwent laparoscopic radical cystectomy with orthotopic ileal neobladder. Five-port transperitoneal approach was applied. The surgical procedure included standard laparoscopic pelvic lymphadenectomy, radical resection of bladder, extracorporeal formation of ileal pouch; extracorporeal implantation of ureters; and laparoscopic urethra-neobladder anastomosis. Erectile nerve sparing procedure was performed for 26 cases. The patients were followed up for 1 - 53 months.


RESULTS
The median operation time was 330 min, and the median blood loss was 320 ml. Conversion to open surgery was not necessary in any of the patients. There was no peri-operative mortality. The complication rate was 18.5% (20/108). Surgical margins were tumor free for all cases. The day-time and night-time continence rates were 90.7% and 82.6% respectively in 6 months postoperatively. 10 of the 26 patients undergoing erectile nerve-sparing procedure had potency for intercourse. Follow-up showed 5 cases with local recurrence, 1 case with trocar site seeding and 6 cases with distant metastasis, 8 of the patients died of tumor-related disease and 3 died of diseases not related to tumor.


CONCLUSIONS
Laparoscopic radical cystectomy with extracorporeal formation of orthotopic ileal neobladder is a feasible technique with low morbidity and acceptable neobladder function.
Lin
Tian-Xin
TX
Department of Urology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.
Huang
Jian
J
Xu
Ke-Wei
KW
Jiang
Chun
C
Huang
Hai
H
Han
Jin-Li
JL
Zhang
Cai-Xia
CX
Yao
You-Sheng
YS
Xie
Wen-Lian
WL
Guo
Zheng-Hui
ZH
Yin
Xin-Bao
XB
Dong
Wen
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent