scholarly journals Clinical Efficacy Analysis of Two Different Surgical Approaches to Laparoscopic Radical Cystectomy with Urinary Diversion for Invasive Bladder Cancer

2020 ◽  
pp. 1-5
Author(s):  
Li-feng Zhang ◽  
Bowen Tang ◽  
Shenglin Gao ◽  
Jiasheng Chen ◽  
Chao Lu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Clinical Efficacy ◽  
Invasive Bladder Cancer ◽  
Intestinal Function ◽  
Sample Sizes ◽  
Advantages And Disadvantages ◽  
Function Recovery ◽  
Larger Sample

Objective: The present study aimed to compare the efficacy, and advantages and disadvantages of laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy versus laparoscopic radical cystectomy + ileal cystoplasty (Bricker procedure) in the treatment of invasive bladder cancer. Method: Forty-five patients (retrospectively registered) with grade II–III bladder invasive urothelial carcinoma were divided into two groups to compare clinical efficacy, operative duration and blood loss, postoperative intestinal function recovery, length of hospitalization, and complications. Those in the ureterocutaneostomy group (n=25) were treated using laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy, while those in the ileal cystoplasty group (n=20) were treated using laparoscopic radical cystectomy + ileal cystoplasty. Results: Laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy shortened the operation, improved patient tolerance, and decreased postoperative intestinal function recovery time. However, its long-term clinical efficacy needs further study using larger sample sizes to confirm these results. Conclusion: Results of this study demonstrated that extraperitoneal bilateral ureterocutaneostomy after cystectomy had advantages of less trauma, a shorter learning curve, less surgical bleeding, and quicker postoperative recovery. Although early and mid-term follow-up revealed a slightly higher incidence of hydronephrosis, the severity of complications was not high in most patients. Nevertheless, the long-term clinical efficacy of this procedure needs further study using larger sample sizes.

Radical Cystectomy in the Treatment of Invasive Bladder Cancer: Long-Term Results in 1,054 Patients

2001 ◽  
Vol 19 (3) ◽  
pp. 666-675 ◽  
Author(s):  
John P. Stein ◽  
Gary Lieskovsky ◽  
Richard Cote ◽  
Susan Groshen ◽  
An-Chen Feng ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Cystectomy ◽  
Bladder Tumor ◽  
Invasive Bladder Cancer ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Node Negative ◽  
Primary Bladder

PURPOSE: To evaluate our long-term experience with patients treated uniformly with radical cystectomy and pelvic lymph node dissection for invasive bladder cancer and to describe the association of the primary bladder tumor stage and regional lymph node status with clinical outcomes. PATIENTS AND METHODS: All patients undergoing radical cystectomy with bilateral pelvic iliac lymphadenectomy, with the intent to cure, for transitional-cell carcinoma of the bladder between July 1971 and December 1997, with or without adjuvant radiation or chemotherapy, were evaluated. The clinical course, pathologic characteristics, and long-term clinical outcomes were evaluated in this group of patients. RESULTS: A total of 1,054 patients (843 men [80%] and 211 women) with a median age of 66 years (range, 22 to 93 years) were uniformly treated. Median follow-up was 10.2 years (range, 0 to 28 years). There were 27 (2.5%) perioperative deaths, with a total of 292 (28%) early complications. Overall recurrence-free survival at 5 and 10 years for the entire cohort was 68% and 66%, respectively. The 5- and 10-year recurrence-free survival for patients with organ-confined, lymph node–negative tumors was 92% and 86% for P0 disease, 91% and 89% for Pis, 79% and 74% for Pa, and 83% and 78% for P1 tumors, respectively. Patients with muscle invasive (P2 and P3a), lymph node–negative tumors had 89% and 87% and 78% and 76% 5- and 10-year recurrence-free survival, respectively. Patients with nonorgan-confined (P3b, P4), lymph node–negative tumors demonstrated a significantly higher probability of recurrence compared with those with organ-confined bladder cancers (P < .001). The 5- and 10-year recurrence-free survival for P3b tumors was 62% and 61%, and for P4 tumors was 50% and 45% , respectively. A total of 246 patients (24%) had lymph node tumor involvement. The 5- and 10-year recurrence-free survival for these patients was 35%, and 34%, respectively, which was significantly lower than for patients without lymph node involvement (P < .001). Patients could also be stratified by the number of lymph nodes involved and by the extent of the primary bladder tumor (p stage). Patients with fewer than five positive lymph nodes, and whose p stage was organ-confined had significantly improved survival rates. Bladder cancer recurred in 311 patients (30%) . The median time to recurrence among those patients in whom the cancer recurred was 12 months (range, 0.04 to 11.1 years). In 234 patients (22%) there was a distant recurrence, and in 77 patients (7%) there was a local (pelvic) recurrence. CONCLUSION: These data from a large group of patients support the aggressive surgical management of invasive bladder cancer. Excellent long-term survival can be achieved with a low incidence of pelvic recurrence.

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