Laparoscopic Radical Cystectomy and Urinary Diversion: Status in 2006

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• 作者：Georges-Pascal Haber ; Jose Roberto Colombo ; Jr. ; Monish Aron ; Osamu Ukimura and Inderbir S. Gill
• 刊名：European Urology Supplements
• 出版年：2006
• 期刊代码：290_15699056
• 类别：med
• 出版时间：November 2006
• 卷：5
• 期：19
• 页码：950-955
• 文件大小：437 K

摘要

Objectives

To discuss the perioperative outcomes and oncologic data of laparoscopic radical cystectomy (LRC) and urinary diversion in the treatment of invasive or high-risk superficial bladder cancer.

Methods

The authors describe their established technique, report their personal experience, review the current worldwide experience, and discuss perspectives concerning LRC and urinary diversion for bladder cancer.

Results

Data reviewed suggest that the laparoscopic approach to radical cystectomy contributes to less blood loss, decreased postoperative pain, and somewhat quicker recovery. Complication rates appear similar to the open approach. Extracorporeal performance of the bowel work and ureteroileal anastomoses have resulted in decreased operative times. A median of 21 lymph nodes were retrieved after laparoscopic extended pelvic lymphadenectomy. In 37 patients, estimated 5-yr overall and cancer-specific survival rates were 63%and 92%, respectively. No port-site metastases or local recurrences were noted.

Conclusions

LRC with extracorporeal urinary reconstruction is emerging as a viable alternative to open radical cystectomy while minimising patient morbidity. Intermediate oncologic outcomes are encouraging and comparable to those of open series.