Comparative analysis of the clinical effect and safety of Laparoscopic Radical Cystectomy + Orthotopic Ileal Neobladder and Open Surgery

Objectives: To explore the clinical effect and safety of laparoscopic radical cystectomy + orthotopic ileal neobladder and open surgery. Methods: The study was conducted at Jingzhou First People’s Hospital from January 2017 to July 2018. In this study 87 patients undergoing radical cystectomy + orthotopic ileal neobladder were chosen and classified into an observation group (48 cases) and a control group (39 cases) according to the surgical methods. The observation group underwent laparoscopic surgery, while the control group underwent open surgery. Perioperative period and prognostic conditions were compared in both groups. Results: The intraoperative bleeding amount obviously decreased. The recovery time of gastroenteric function and postoperative hospitalization time were significantly shortened. Postoperative pain was significantly alleviated. Compared with the control group, the observation group showed significant differences (P<0.05). The time, amount and difference in pelvic lymph node dissection in both groups were not significantly different (P>0.05). The differences in both groups in terms of the daytime/nighttime urinary continence rate, maximum urinary flow rate, internal bladder pressure, maximum bladder pressure during urination, internal urethral pressure, bladder capacity, and residual urine volume six months after the operation were not statistically significant (P>0.05). There was no significant difference in postoperative complications, including urinary fistula, bleeding, urinary tract infection, pulmonary infection, dysuria, lymphatic leakage, ureterostenosis, or relapse (P>0.05). The ileus incidence rate in the observation group was obviously lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Laparoscopic radical cystectomy + orthotopic ileal neobladder has the characteristics of limited trauma, a minimal amount of bleeding and a fast recovery. The functions of orthotopic neobladders are good, and the occurrence rate of postoperative complications is low. In addition, body immunity is protected. Hence, this procedure deserves to be promoted clinically. doi: https://doi.org/10.12669/pjms.37.1.2273 How to cite this:Liu YH, Dai HT, Liu CM, Zheng J. Comparative analysis of the clinical effect and safety of Laparoscopic Radical Cystectomy + Orthotopic Ileal Neobladder and Open Surgery. Pak J Med Sci. 2021;37(1):59-64. doi: https://doi.org/10.12669/pjms.37.1.2273 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Đánh giá kết quả điều trị ung thư bàng quang xâm lấn lớp cơ bằng phẫu thuật cắt bàng quang triệt căn để lại vỏ tuyến tiền liệt kết hợp nạo hạch chậu mở rộng và tạo hình bàng quang từ hồi tràng

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2021.74.7 ◽

2021 ◽

Author(s):

Ngoc Khanh Tran

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Statistical Significance ◽

Pelvic Lymphadenectomy ◽

Invasive Bladder Cancer ◽

Urinary Continence ◽

Control Group ◽

Ileal Neobladder ◽

Estimated Blood Loss ◽

Orthotopic Ileal Neobladder

TÓM TẮT Đặt vấn đề: Phẫu thuật cắt bỏ toàn bộ bàng quang được xem là phẫu thuật tiêu chuẩn đối với ung thư bàng quang xâm lấn. Tạo hình bàng quang mới từ hồi tràng, cũng như nạo vét hạch nhằm tránh di căn và nâng cao tỉ lệ sống sau 5 năm rất quan trọng. Bên cạnh đó, chất lượng cuộc sống của bệnh nhân sau phẫu thuật cũng rất đáng quan tâm. Mục tiêu: Đánh giá kết quả điều trị ung thư bàng quang xâm lấn lớp cơ bằng phẫu thuật cắt bàng quang triệt căn để lại vỏ tuyến tiền liệt kết hợp nạo hạch chậu mở rộng và tạo hình bàng quang từ hồi tràng. Nội dung và phương pháp nghiên cứu: Nghiên cứu tiến cứu, mô tả lâm sàng không nhóm chứng 43 bệnh nhân nam được chẩn đoán ung thư bàng quang xâm lấn (cT2a - T4aN0M0), được phẫu thuật cắt bàng quang triệt căn để lại vỏ tuyến tiền liệt, nạo hạch chậu mở rộng và tạo hình bàng quang mới từ hồi tràng từ tháng 1/2015 đến 12/2020 tại khoa ngoại Tổng hợp BVTW Huế. Kết quả: Thời gian phẫu thuật trung bình: 213,5 ± 29,7 phút. Lượng máu mất trung bình: 130 ± 90 ml. Lấy được 11,5 ± 4,5 hạch. Thời gian nằm viện trung bình: 17,12 ± 6,45 ngày. Tỷ lệ biến chứng sớm sau mổ 32,6%. Đa số bệnh nhân khi xuất viện đều tiểu được nhưng tia tiểu yếu, tiểu són, thể tích nước tiểu ít dưới 150 ml.Thể tích bàng quang tăng có ý nghĩa qua các lần tái khám (p < 0,05). Tỷ lệ kiểm soát tiểu tiện ban ngày: 97,2% sau 6 tháng. 1/43 tái phát tại miệng nối bàng quang - niệu đạo sau 4 tháng. 7 trường hợp tử vong do ung thư tiến triển. Kết luận: Cắt bàng quang triệt căn để lại vỏ tuyến tiền liệt, nạo hạch chậu mở rộng và tạo hình bàng quang mới từ đoạn ruột non theo phương pháp Hautmann - Studer vẫn giải quyết triệt để vấn đề ung thư học, giảm khả năng tái phát di căn hạch, bệnh nhân vẫn còn khả năng tình dục và tiểu tự chủ sau mổ. ABSTRACT OUTCOMES OF INVASIVE BLADDER CANCER TREATED BY PROSTATE SPARING RADICAL CYSTECTOMY WITH EXTENDED PELVIC LYMPHADENECTOMY AND ORTHOTOPIC ILEAL NEOBLADDER Background: Radical cystectomy is considered a “gold standard” procedure to treat invasive bladder cancer. Orthotopic ileal neobladder after cystectomy as well as lymphadenectomy, which avoids metastasis and enhances postoperative 5 - years survival rate are important. Moreover, the quality of life after this kind of surgery is a great concern. Purpose: Evaluating results of treatment of invasive bladder cancer by prostate sparing radical cystectomy with extended pelvic lymphadenectomy and orthotopic ileal neobladder. Material and Method: Prospective and descriptive clinical study without a control group in 43 males who were diagnosed with invasive bladder cancer (cT2a - T4aN0M0), they underwent prostate sparing radical cystectomy with extended pelvic lymphadenectomy and orthotopic ileal neobladder, from 1/2015 to12/2020 at Department of General Surgery, Hue Central Hospital. Results: The operative time: 213,5 ± 29,7 min. The estimated blood loss: 130 ± 90 ml. The mean number of lympho nodes which is conducted lymphadenectomy: 11,5 ± 4,5. The length of hospital stay: 17,12 ± 6,45 days. Early complication rate: 32,6%. The majority of patients who were discharged from the hospital passed urine with urinary incontinence, weak urine stream and voided volume < 150ml. The volume of the neobladder increased with statistical significance through follow - up examinations (p < 0,05). The daytime continence rate was 97,2% after 6 months. 1/43 case recured at cystourethral anastomosis after 4 months. 7 cases dead due to cancer progression. Conclusion: Prostate sparing radical cystectomy with extended pelvic lymphadenectomy and Hautmann - Studer orthotopic ileal neobladderstill thoroughly solve oncologic issues, reduce the possibility of lymph node metastasis recurrence. The patient still has the sexual ability and urinary continence after this procedure. Keywords: Extended pelvis lymphadenectomy; invasive bladder cancer; radical cystectomy; orthotopic ileal neobladder.

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A comparative study between open and laparoscopic approach in radical cystectomy with orthotopic ileal neobladder

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2015.01.005 ◽

2015 ◽

Vol 39 (2) ◽

pp. 92-97

Author(s):

E. Mateo ◽

A. García-Tello ◽

F. Ramón de Fata ◽

I. Romero ◽

C. Núñez-Mora ◽

...

Keyword(s):

Comparative Study ◽

Radical Cystectomy ◽

Laparoscopic Approach ◽

Ileal Neobladder ◽

Orthotopic Ileal Neobladder

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Comment: “Laparoendoscopic radical cystectomy with orthotopic ileal neobladder through umbilical single port”

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2012.05.013 ◽

2012 ◽

Vol 36 (9) ◽

pp. 562-563

Author(s):

J.H. Kaouk ◽

R. Autorino

Keyword(s):

Radical Cystectomy ◽

Single Port ◽

Ileal Neobladder ◽

Orthotopic Ileal Neobladder

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Analysis of the clinical value of Baogan Lishui decoction and convetional western medicine in treating Hepatitis B cirrhosis refractory ascites

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v2i4.411 ◽

2018 ◽

Vol 2 (4) ◽

Author(s):

Huaide Lin

Keyword(s):

Chinese Medicine ◽

Hepatitis B ◽

Combination Treatment ◽

Western Medicine ◽

Clinical Effect ◽

Refractory Ascites ◽

Control Group ◽

Observation Group ◽

Quality And Safety ◽

Clinical Value

Objective: To investigate the clinical effect of combination treatment of Chinese medicine Baogan Lishui decoction and western medicine on hepatitis B cirrhosis related refactory ascites.Method: Control group was given conventional western medicine therapy while the observation group was given same conventional western medicine therapy with additional of Chinese medicine Baogan Lishui decoction.Result: The total effective of clinical treatment on hepatitis B cirrhosis related refractory ascites in observation group was higher than that of the control group which was 88.89% compared to 71.11%, respectively and it was significant different (p<0.05).Conclusion: The combination treatment of Chinese medicine Baogao Lishui decoction and conventional western medicine can significantly increased the treatment effect on hepatitis B cirrhosis refractory ascites, and thus increases the quality and safety of life.

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Effect of iRoot BP Plus Pulpotomy for Immediate Repair in Children with Young Permanent Teeth Crown Fracture

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i2.1086 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Jiaying Song

Keyword(s):

Success Rate ◽

Clinical Effect ◽

Permanent Teeth ◽

Control Group ◽

Observation Group ◽

Control Groups ◽

Before And After ◽

Random Number Table ◽

The Difference ◽

And Control

Objective: To explore the clinical effect of iRoot BP Plus pulpotomy for immediate repair in children with young permanent teeth crown fracture. Methods: From September 2017 to October 2018, 80 children (80 affected teeth) with young permanent teeth crown fracture who treated in the hospital were selected as the research objects. Random number table method was used to divide them into observation and control groups with each group of forty patients (40 affected teeth). The children in the control group were treated with calcium hydroxide resin, while the observation group were treated with iRoot BP Plus for immediate repair. The surgical success rate was compared between the two groups, and the pulp vitality before and after treatment were compared. Results: At 3 months and 6 months after surgery, the success rate of children in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). The percentage of children with negative pulp activity in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Immediate repair with iRoot BP Plus pulpotomy in children with young permanent teeth crown fracture has significant clinical effect.

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Comparison of laparoscopic surgery versus traditional laparotomy for the treatment of emergency patients

Journal of International Medical Research ◽

10.1177/0300060519889191 ◽

2019 ◽

Vol 48 (3) ◽

pp. 030006051988919

Author(s):

Ning Cui ◽

Jun Liu ◽

Haiyan Tan

Keyword(s):

Laparoscopic Surgery ◽

Postoperative Complications ◽

Gastrointestinal Surgery ◽

Length Of Hospital Stay ◽

Control Group ◽

Observation Group ◽

Duration Of Surgery ◽

Clinical Benefits ◽

Gastrointestinal Emergency ◽

And Control

Objective To investigate the clinical efficacy of laparoscopic gastrointestinal emergency surgery and postoperative complications. Methods Data for 604 patients undergoing emergency gastrointestinal surgery between January 2013 and December 2018 were analyzed retrospectively. Treatment efficacy and postoperative complications were compared between 300 patients (control group) undergoing traditional laparotomy and 304 patients (observation group) undergoing laparoscopic surgery. Results Clinical features were significantly better in the observation group than in the control group, including duration of surgery (59.12 ± 10.31 minutes vs. 70.34 ± 12.83 minutes), intraoperative blood loss (41.21 ± 10.45 mL vs. 61.38 ± 9.97 mL), postoperative pain score (1.25 ± 0.25 points. vs. 5.13 ± 0.43 points), length of hospital stay (5.13 ± 0.24 days vs. 7.05 ± 0.13 days), and time to free activity (13 ± 2.96 hours vs. 22 ± 3.02 hours). The total complication incidence in the observation group was 3.9%, compared with 16% in the control group (16%). No significant differences in direct medical costs were recorded between the observation and control groups. Conclusions For patients undergoing emergency gastrointestinal surgery, laparoscopic surgery resulted in better clinical outcomes than traditional laparotomy without incurring additional costs. The potential clinical benefits of emergency laparoscopic gastrointestinal surgery warrant further study.

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