title: A feasibility study of peritoneum preservation in radical cystectomy with extraperitonealization of orthotopic neobladder for invasive high-grade bladder cancer: a preliminary analysis.
abstract: OBJECTIVE
  To describe a technique for radical cystectomy with extraperitonealization of orthotopic neobladder (RCEN) that reduces bowel-related complications by preservation of the peritoneum.
  
  
  METHODS
  Fifteen patients with non-metastatic bladder cancer underwent RCEN by a peritoneum preserving technique. The study included 13 patients with T1 high-grade bladder cancer and 2 with T2a bladder cancer. To compare perioperative outcomes including bowel-related complications, we also reviewed 15 patients who underwent traditional cystectomy with ileal Studer neobladder who were matched for age, sex, body mass index, American Society of Anesthesiologists (ASA) score, tumor stage, tumor grade, tumor size, and location. Female genital organs were preserved in five female patients who underwent the RCEN technique.
  
  
  RESULTS
  There was no significant difference between the two cohorts (RECN vs. traditional technique) with respect to age, body mass index, ASA score, or tumor characteristics. The mean operative time was similar between the two groups. The patients who underwent RECN exhibited earlier recovery of normal gas pattern on plain abdominal X-ray during the postoperative period and an earlier resumption of normal diet. The mean hospital stay was shorter in the RECN group than the traditional group.
  
  
  CONCLUSIONS
  The RECN technique preserving the whole peritoneum is a feasible approach that significantly reduces bowel-related complications in selected patients.
authors.affiliation: Department of Urology, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Songnam, 463-712, Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Park
authors.forename: In Hyuck
authors.initials: IH
authors.lastname: Gong
authors.forename: Don Kyung
authors.initials: DK
authors.lastname: Choi
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Hwang
authors.forename: Moon Hyung
authors.initials: MH
authors.lastname: Kang
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005836:Genitalia, Female; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods*; D010537:Peritoneum; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D016476:Urinary Reservoirs, Continent