title: Combined Extraperitoneal and Transperitoneal Laparoscopic Extended Partial Cystectomy for the Treatment of Urachal Carcinoma.
abstract: OBJECTIVE
  To evaluate the application of laparoscopic extended partial cystectomy (PC) and bilateral extended pelvic lymph node dissection (PLND) for the treatment of urachal carcinomas (UrCs).
  
  
  METHODS
  Combined laparoscopic extended PC and bilateral extended PLND was performed in 16 cases with UrCs in our hospital between April 2009 and December 2012. The surgical procedure included the dilation of the extraperitoneal space, circumscription of the umbilicus, dissection from the umbilicus caudad to the dome of the bladder, excision of the tumor, and the suture of the bladder. The average age of the patients was 52.8 years (35-73 years). The average tumor size was 3.2 cm (1.5-5.6 cm). A median follow-up period of 36 months was obtained to evaluate patient survival and recrudescence.
  
  
  RESULTS
  All 16 procedures were completed laparoscopically without open conversion. The median operation time was 85 minutes (65-125 minutes), with a median estimated blood loss of 50 mL (30-110 mL). The median hospital stay was 5 days (4-7 days). The bladder margins were negative in all cases. However, five cases were confirmed postoperatively with positive lymph nodes. No intraoperative or postoperative complications occurred. Histopathology confirmed mucous urachal adenocarcinoma in 11 cases, mixed carcinoma in 1 case, and papillary adenocarcinoma in 4 cases. After a median follow-up period of 36 months, the 2- and 3-year survival rates were 62.5% (10/16) and 50% (8/16), respectively.
  
  
  CONCLUSIONS
  Combined laparoscopic extended PC and bilateral extended PLND is a safe and feasible method for treating patients with urachal malignancy.
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Baojun
authors.initials: B
authors.lastname: Wang
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Xintao
authors.initials: X
authors.lastname: Li
authors.affiliation: 2 Department of Urology, Changhai Hospital, Second Military Medical University , Shanghai, China .
authors.forename: Shaoxiong
authors.initials: S
authors.lastname: Ming
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Hongzhao
authors.initials: H
authors.lastname: Li
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Qing
authors.initials: Q
authors.lastname: Ai
authors.affiliation: 1 Department of Urology, Medical College of People's Liberation Army, Chinese People's Liberation Army General Hospital , Beijing, China .
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D010537:Peritoneum; D016896:Treatment Outcome; D047368:Tumor Burden; D014472:Umbilicus; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*