title: Retrograde radical cystectomy and consequent peritoneal cavity reconstruction benefits localized male bladder cancer: results from a cohort study.
abstract: BACKGROUND
  Bladder cancer is the second most common genitourinary malignancy. Our study was to introduce a standardized surgical procedure of retrograde radical cystectomy and consequent peritoneal cavity reconstruction in localized male bladder cancer.
  
  
  METHODS
  Eighty-four consecutive male patients with localized bladder cancer (clinical stage T2 or lower) underwent surgery in our institute with the proposed procedure between May 2012 and April 2013. Median age was 65 years (range, 35 to 83 years); patient characteristics, surgical parameters, perioperative complications, pathology, and short-term prognosis were analyzed. Median follow-up was 24 months (range, 18 to 30 months).
  
  
  RESULTS
  The complete procedure including urinary diversion took 4.0 h (2.2 to 5.0 h), with a median exposed peritoneal cavity of 45 min (0 to 75 min); the median blood loss was 140 ml (50 to 600 ml), and 2 patients needed transfusion; neurovascular bundles were reserved in 76 cases; the median abdominal and pelvic drainage was 9.0 days (6 to 15 days), the median gastrointestinal recovery was 2.5 days (1 to 12 days), and the median postoperative hospital stay was 13.0 days (10 to 21 days). Four patients had severe surgical complications, and two had mild to moderate ileus, with recovery in 1 and 2 weeks with supportive treatment. No perioperative deaths or postoperative recurrence were reported.
  
  
  CONCLUSIONS
  The surgical procedure in male localized bladder cancer described in the present study provided surgical facilities, with limited abdominal organ disturbance and satisfactory tumor control. The procedure was associated with good gastrointestinal recovery, few postoperative complications, and a short hospital stay.
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. xiaojianqin@188.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. xiaojianqin@188.com.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. zhanghl918@163.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. zhanghl918@163.com.
authors.forename: Hailiang
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. 06301010190@fudan.edu.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. 06301010190@fudan.edu.cn.
authors.forename: Fangning
authors.initials: F
authors.lastname: Wan
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. qdzhuyiping@gmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. qdzhuyiping@gmail.com.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. yijunshen@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. yijunshen@shca.org.cn.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. bodai1978@126.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. bodai1978@126.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Dai
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. guohaishi@126.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. guohaishi@126.com.
authors.forename: Guohai
authors.initials: G
authors.lastname: Shi
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. mailzhuyao@163.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. mailzhuyao@163.com.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, No. 270 Dong' an Road, Shanghai, 200032, China. dwyeli@163.com.|Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong' an Road, Shanghai, 200032, China. dwyeli@163.com.
authors.forename: Dingwei
authors.initials: D
authors.lastname: Ye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010529:Peritoneal Cavity / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D019651:Plastic Surgery Procedures; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*