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



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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%
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The nighttime continence rate: 82.6%
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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
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Local recurrence
5
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Trocar site seeding
1
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Distant metastasis
6
(liver 3, Lung1, bone 2)
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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