Is Robot-assisted Radical Cystectomy the Preferred Minimal Invasive Procedure for Non-advanced Bladder Urothelial Carcinoma(T1-T2N0M0)? A Single Center Retrospective Study.

2020 ◽  
Author(s):  
Ming Xiao ◽  
Zhaohui Zhong ◽  
Jiannan Ren ◽  
Wei Xiong
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Postoperative Treatment ◽  
Transfusion Rate ◽  
Robot Assisted ◽  
Bladder Urothelial Carcinoma ◽  
Hospitalization Costs

Abstract Background: To investigate the perioperative efficacy and cost of robot-assisted radical cystectomy(RARC) and laparoscopic RC(LRC) in patients with non-advanced bladder urothelial carcinomaMethods: 156 patients with non-advanced bladder urothelial carcinoma undergoing minimally invasive radical cystectomy in our center between January 2015 and April 2020 were included. Perioperative data and hospitalization expenses were extracted from our database. All analyses were performed using SPSS 23.0 software, and p < 0.05 was considered statistically significant.Results: The proportion of male patients was 86.5%(135/156) and the median age was 65(IQR 59-71) years old. RARC had a lower PSM rate (0 vs 5.3%,P=0.051), longer median operation time(370 vs 305 min,P<0.001) and higher median hospitalization cost(20565.2 vs 15532.4$,P<0.001). There were no significant differences in intraoperative transfusion rate, anesthesia resuscitation in ICU, postoperative hospital stay, 30-d complications and postoperative treatment expenses between the two groups(P=0.815,0.715, 0.817,0.92 and 0.543,respectively.)Conclusion: Short operation time and low hospitalization costs are favorable factors for LRC, but RARC may be the preferred surgical procedure for non-advanced bladder urothelial carcinoma considering the potentially low PSM rate.Trial registration: A complete informed consent was obtained from the patient and their families before the surgery.Informed consent was signed for all patients.This study was approved by the Ethics Review Committee of the Second Xiangya Hospital of Central South University

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

scholarly journals Case Report: Metachronous bilateral upper tract and bladder urothelial carcinoma: a long-term follow-up

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 778
Author(s):  
Agus Rizal Ardy Hariandy Hamid ◽  
Fakhri Zuhdian Nasher ◽  
Meilania Saraswati ◽  
Sahat Matondang ◽  
Chaidir Arif Mochtar
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Upper Urinary Tract ◽  
Urothelial Cell ◽  
Laser Evaporation ◽  
Ureteral Orifice ◽  
Upper Tract ◽  
Bladder Urothelial Carcinoma ◽  
Carcinoma Of The Bladder ◽  
The Right

Background: Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to the ureteral orifice. Urothelial carcinoma is a multifocal malignant tumor which tends to reoccur after treatment. Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients. The occurrence of contralateral UTUC after nephroureterectomy is rarer with a prevalence of 0.5%. Case presentation: The case of a 43-year-old male with metachronous bilateral UTUC was reported. The patient had undergone gemcitabine-cysplatine neoadjuvant chemotherapy followed by radical cystectomy and orthotopic neobladder for urothelial carcinoma of the bladder cT2N0M0. Left hydronephrosis was discovered three months after the procedure. The patient was diagnosed with left UTUC cT4N0M0 of renal pyelum after a series of examinations. A left open radical nephroureterectomy was conducted to remove the mass followed by adjuvant chemotherapy. This was followed up with routine ultrasound and magnetic resonance imaging (MRI) every three months with a “tumor-free” period of 26 months. Meanwhile, the patient was re-admitted with fever and an increase in creatinine value of 4.3. After further workups, the patient was diagnosed with UTUC cT2N0M0 of the right renal pyelum. A kidney sparring approach with laser evaporation of the tumor was conducted followed by eight cycles of Gemcitabine intracavity antegrade per nephrostomy. After the regimen was finished, an MRI evaluation was conducted to assess treatment results, and the mass had decreased. Conclusions: This report showed a rare case of urothelial cell carcinoma recurrences. From bladder urothelial carcinoma to left UTUC and then to contralateral UTUC. It is important to evaluate the upper tract to reduce the risk of recurrence.

scholarly journals Vaginal metastasis of bladder urothelial carcinoma: Description of a case and revision of literature

2017 ◽  
Vol 89 (2) ◽  
pp. 156 ◽  
Author(s):  
Carmelo A. Di Franco ◽  
Daniele Porru ◽  
Giovanni Giliberto ◽  
Alessandra Viglio ◽  
Bruno Rovereto
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Vaginal Bleeding ◽  
Urothelial Cancer ◽  
Vaginal Wall ◽  
Rare Entity ◽  
Bladder Urothelial Carcinoma ◽  
Vaginal Metastasis ◽  
History Of

Vaginal metastases from urothelial cancer are a rare entity and in literature, few cases are described. We report a case of a 68 year-old woman with history of bladder urothelial carcinoma underwent to radical cystectomy who came in our department after 5 months for pelvic pain and vaginal bleeding. Objective examination revealed an ulcerative, solid vaginal lesion in the upper vaginal wall. We performed a vaginal biopsy that showed urothelial carcinoma compatible with the primitive bladder cancer. The patient underwent to surgery and was sent to oncological evaluation.

Robot-assisted transthoracic first rib resection for venous thoracic outlet syndrome

Vascular ◽  
2021 ◽  
pp. 170853812199733
Author(s):  
Frank Hoexum ◽  
Vincent Jongkind ◽  
Hans ME Coveliers ◽  
Kak K Yeung ◽  
Willem Wisselink
Keyword(s):  
Blood Loss ◽  
Functional Outcomes ◽  
Thoracic Outlet Syndrome ◽  
Operation Time ◽  
Minimal Invasive ◽  
Robot Assisted ◽  
Rib Resection ◽  
First Rib ◽  
First Rib Resection

Background Venous thoracic outlet syndrome (vTOS) is caused by external compression of the subclavian vein at the costoclavicular junction. It can be subdivided in McCleery Syndrome and Paget-Schroetter Syndrome (PSS). To improve the venous outflow of the arm and to prevent recurrent thrombosis, first rib resection with venolysis of the subclavian vein can be performed. Open transaxillary, supraclavicular, infraclavicular or combined paraclavicular approaches are well known, but more recent robot-assisted techniques are introduced. We report our short- and long-term results of a minimal invasive transthoracic approach for resection of the anteromedial part of the first rib using the DaVinci surgical robot, performed through three trocars. Methods We analyzed all patients with vTOS who were scheduled to undergo robot-assisted transthoracic first rib resection in the period July 2012 to May 2016. Outcomes were: technical success, operation time, blood loss, hospital stay, 30-day complications and patency. Functional outcomes were assessed using the “Disability of the Arm, Shoulder and Hand” (DASH) questionnaire. Results Fifteen patients (8 male, 7 female; mean age 32.9 years, range 20–54 years) underwent robot-assisted transthoracic first rib resection. Conversion to transaxillary resection was necessary in three patients. Average operation time was 147.9 min (range 88–320 min) with a mean blood loss of 79.5 cc (range 10–550 cc). Mean hospital stay was 3.5 days (range 2–9). In three patients, complications were reported (Clavien-Dindo grade 2–3a). Patency was 91% at 15.5 months’ follow-up. DASH scores at one and three years showed excellent functional outcomes (7.1 (SD= 6.9, range 0–20.8) and 6.0 (SD= 6.4, range 0–25)) and are comparable to the scores of the normative general population. Conclusion Robot-assisted transthoracic first rib resection with only three trocars is a feasible minimal invasive approach for first rib resection in the management of vTOS. This technique enables the surgeon to perform venolysis under direct 3D vision with good patency and long-term functional outcome. Studies with larger cohort size are needed to compare the outcomes of this robot-assisted technique with other more established approaches.

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