Transcript 幻灯片 1
Laparoscopic Radical Cystectomy
with Orthotopic Ileal Neobladder:
Sun Yat Sen University Experience
Huang Jian, Lin Tianxin, Xu Kewei, Huang Hai, Yao Yousheng et al
Urology Department
The 2nd Affiliated Hospital ,Sun Yat-sen University, Guangzhou China
The Second Affiliated Hospital of Sun Yat-Sen University
The Objectives
Laparoscopic radical cystectomy is more and more
accepted by doctors and patients.
Standard operation procedure has not yet been
established.
Report our technique improvements of LRC and
early results.
The Second Affiliated Hospital of Sun Yat-Sen University
Patients data
From Dec.2002 to May 2007
108 cases (96 male, 12 female)
All with bladder cancer
Follow up: 28 months(1~53 months)
The Second Affiliated Hospital of Sun Yat-Sen University
Patient’s Position
The Second Affiliated Hospital of Sun Yat-Sen University
Surgical Procedures:
The Second Affiliated Hospital of Sun Yat-Sen University
Pathologcal findings
stage:T1
cases: 7
T2 T3
66 33
grade:G1
cases: 9
G2
75
LN(-): 95
LN(+): 13
T4a Tis Associated
2
3
G3
24
TCC 102,SCC 3,AC 1,TCC+AC 2
The Second Affiliated Hospital of Sun Yat-Sen University
Results
The operation time : 330min (210~600min)
The blood loss: 320ml(50~1000ml)
The daytime continence rates: 90.7%
The nighttime continence rate: 82.6%
The neobladder capacity : 343 ml (230~540ml)
The Second Affiliated Hospital of Sun Yat-Sen University
Postoperative IVU
The Second Affiliated Hospital of Sun Yat-Sen University
Cystourethrography
The Second Affiliated Hospital of Sun Yat-Sen University
Small ureteral nipple
in cystoscopy
The Second Affiliated Hospital of Sun Yat-Sen University
Post-operative major complications
vesico-urethral anastomotic leakage
vesico-urethral anastomotic stricture
uretero-pouch anastomotic stricture
Proloned Lymphatic leakage
pouch-vaginal fistula
ileal anastomotic leakage
colon-pouch fistula
ileo-pouch fistula
pneumonia
Pyelonephritis
Ileus
Complication rate
18.5%
3
2
3
3
1
1
1
1
1
1
3
The Second Affiliated Hospital of Sun Yat-Sen University
Oncological outcomes
Local recurrence
5
Trocar site seeding
1
Distant metastasis
6
(liver 3, Lung1, bone 2)
died
11
The Second Affiliated Hospital of Sun Yat-Sen University
Conclusions
Laparoscopic radical cystectomy with extracorporeal
formation of neobladder is a feasible procedure with
low morbidity and acceptable neobladder function.
Long term follow-up is needed to confirm the
oncological outcomes.
The Second Affiliated Hospital of Sun Yat-Sen University
The Second Affiliated Hospital of Sun Yat-Sen University