title: Laparoscopic complete urinary tract exenteration with the specimen withdrawn transvaginally.
abstract: OBJECTIVE To describe the technique of laparoscopic complete urinary tract exenteration (LaCUTE), where specimens are withdrawn en bloc through the vagina, and to compare our results for patients had this procedure with those who had surgery by traditional open methods PATIENTS AND METHODS From February 2006 to June 2008, five patients had LaCUTE and three CUTE at our institute. The surgical procedure included bilateral nephroureterectomy, bilateral pelvic lymphadenectomy, radical cystourethrectomy, radical hysterectomy, bilateral salpingo-oophorectomy. RESULTS In the LaCUTE group the mean (range) patient age was 58 (46-73) years, the blood loss was 378 (290-490) mL, the operative duration was 492 (405-560) min and the hospital stay was 12.2 (9-17) days. All patients had negative surgical margins on pathological examination. The LaCUTE group had significantly less blood loss but longer surgery than the open group. At a mean follow-up of 14.5 and 16.0 months, respectively, there was no evidence of recurrent cancer in both groups. CONCLUSIONS With further experience and improvement in surgical techniques, LaCUTE with vaginal specimen en bloc withdrawal will become feasible for uraemic female patients with urothelial cancer.
authors.affiliation: Department of Urology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Ching-Chia
authors.initials: CC
authors.lastname: Li
authors.forename: Hsun-Shuan
authors.initials: HS
authors.lastname: Wang
authors.forename: Wen-Jeng
authors.initials: WJ
authors.lastname: Wu
authors.forename: Yii-Her
authors.initials: YH
authors.lastname: Chou
authors.forename: Chia-Chu
authors.initials: CC
authors.lastname: Liu
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Long
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Hus
authors.forename: Chieh-Han
authors.initials: CH
authors.lastname: Chuang
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Jang
authors.forename: Shu-Pin
authors.initials: SP
authors.lastname: Huang
authors.forename: Yung-Shun
authors.initials: YS
authors.lastname: Juan
authors.forename: Chun-Hsiung
authors.initials: CH
authors.lastname: Huang
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D013048:Specimen Handling / Q000379:methods*; D016896:Treatment Outcome; D014511:Uremia / Q000150:complications / Q000601:surgery*; D014551:Urinary Tract / Q000601:surgery*; D014571:Urologic Neoplasms / Q000150:complications / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*