The clinical application of robot-assisted radical cystectomy and orthotopic ileal neo-bladder for the treatment of the urothelial carcinoma of bladder
Xiong Wei1, Lyu Ji1, Guo Pu1, Du Yangchun1, Liu Jie1, Chen Fang1, Yang Nian1, Dou Ke1, Ran Qing1
1 Unit of Transplantation and Urology, Department of Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China;
2 Department of Surgery, Sichuan Provincial Women and Children's Central Hospital;
3 Robotic Minimally invasive Surgery Center, Department of Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital
Abstract：Objective: To study the safety and clinical efficacy of robot-assisted radical cystectomy and orthotopic ileal neo-bladder in patients with the urothelial carcinoma of bladder. Methods: The clinical data of 53 patients with bladder urothelial carcinoma undergoing robot-assisted radical cystectomy from November 2014 to April 2017 were analyzed and summarized on peri-operative and follow-up data including tumor pathology and function recovery. Results: The robotic-assisted radical cystectomy was successfully performed on 52 patients, and orthotopic ileal neo-bladder was done on 46 patients of them. There were no transfusion cases, and postoperative pathology surgical margin was negative. Three patients had concurrence of prostate cancer. The Foley catheter was removed one week after confirming no bladder-urethral anastomotic leakage and removing bilateral ureteral stents, and the average hospital stay was 22 d (12-33 d). The average daytime urinary continence was 27 d (1-71 d). Renal function was normal in all cases, and during the follow up period no hydronephrosis of upper urinary tract was found. Conclusions: Robot-assisted radical cystectomy and orthotopic ileal neo-bladder is feasible and safe upon the outcomes of preliminary surgery and short-term follow-up. The advantages of robotic surgical system render the smooth implementation of radical cystectomy, meanwhile preserving the neurovascular bundle and pelvic structure helps full recovery of urinary continence after surgery. To improve the long-term outcomes needs more experience and to comprehensively evaluate these techniques needs the controlled clinical trial.
熊玮, 吕骥, 郭璞, 杜杨春, 刘杰, 陈放, 杨年, 窦科, 冉清. 机器人辅助根治性膀胱切除和原位回肠新膀胱术的临床应用[J]. 微创泌尿外科杂志, 2017, 6(5): 261-265.
Xiong Wei, Lyu Ji, Guo Pu, Du Yangchun, Liu Jie, Chen Fang, Yang Nian, Dou Ke, Ran Qing. The clinical application of robot-assisted radical cystectomy and orthotopic ileal neo-bladder for the treatment of the urothelial carcinoma of bladder. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(5): 261-265.
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