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Baio R, Molisso G, Pane A, Di Mauro U, Intilla O, Sanseverino R. Single-session laparoscopic cystectomy and nephroureterectomy: is it real and useful choice of treatment or fiction? J Surg Case Rep 2021; 2021:rjab409. [PMID: 34512951 PMCID: PMC8428153 DOI: 10.1093/jscr/rjab409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/21/2021] [Indexed: 11/22/2022] Open
Abstract
Patients with recurrent high grade and/or muscle-invasive bladder cancer and concomitant upper urinary tract disease, e.g. urothelial tumors or afunctional hydronephrotic kidneys, may be candidates for simultaneous laparoscopic cystectomy and nephroureterectomy. So, such patients, especially when affected by multiple comorbidities, can benefit from the avoidance of extended laparotomy. We report our experience with simultaneous laparoscopic radical cystectomy and right nephroureterectomy in a 67-year-old-male patient affected by recurrent polyfocal high grade bladder cancer and an associated right upper tract carcinoma. This laparoscopic approach was technically successful without the need for conversion to open surgery. More than a year after the surgery, the patient is still alive, showing no tumor relapse of at the established instrumental controls. This laparoscopic approach, performed in a single session, can be safe and feasible in selected cases as an alternative approach to the open surgery, offering good oncological and functional results.
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Affiliation(s)
- Raffaele Baio
- Department of Medicine and Surgery 'Scuola Medica Salernitana', University of Salerno, Baronissi, Salerno, Italy
| | - Giovanni Molisso
- Department of Urology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
| | - Alessandro Pane
- Department of Urology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
| | - Umberto Di Mauro
- Department of Urology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
| | - Oliviero Intilla
- Department of Urology, Umberto I Hospital, Nocera Inferiore, Salerno, Italy
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Petruţ B, Coman RA, Hârdo V, Coste B, Maghiar T. Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection. Med Pharm Rep 2020; 93:390-395. [PMID: 33225265 PMCID: PMC7664718 DOI: 10.15386/mpr-1626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/11/2020] [Accepted: 06/01/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIMS In patients with recurrent high grade or muscle-invasive bladder cancer and concomitant upper urinary tract tumors or non-functional kidney laparoscopic radical cystectomy and nephroureterectomy with lomboaortic and pelvic lymph node dissection can be performed. We present our initial experience. METHODS Between 2018 and 2019, 4 patients underwent laparoscopic radical cystectomy and unilateral nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection. The nephroureterectomy was the first part of the surgery. It was followed by radical cystectomy with lymphadenectomy. All the specimens were removed en bloc in an endobag through a midline incision. RESULTS The patients' demographic characteristics and perioperative outcomes were retrospectively collected and evaluated. All surgeries were completed laparoscopically. There was no need for conversion to open surgery. The mean operative time was 286,25 min with minimal blood loss (260 ml). No major complications were reported. The mean follow-up period was 8.75 months. CONCLUSION Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection can be safe and feasible in selected cases as an alternative approach to the open surgery, offering good oncological and functional results.
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Affiliation(s)
- Bogdan Petruţ
- Urology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Urology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania
- Urology Department, Pelican Hospital, Oradea, Romania
| | - Roxana-Andra Coman
- Urology Department, "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Romania
| | - Vlad Hârdo
- Urology Department, Pelican Hospital, Oradea, Romania
| | - Bogdan Coste
- Urology Department, Pelican Hospital, Oradea, Romania
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Albisinni S, Oderda M, Fossion L, Varca V, Rassweiler J, Cathelineau X, Chlosta P, De la Taille A, Gaboardi F, Piechaud T, Rimington P, Salomon L, Sanchez-Salas R, Stolzenburg JU, Teber D, Van Velthoven R. The morbidity of laparoscopic radical cystectomy: analysis of postoperative complications in a multicenter cohort by the European Association of Urology (EAU)-Section of Uro-Technology. World J Urol 2015; 34:149-56. [PMID: 26135307 DOI: 10.1007/s00345-015-1633-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/24/2015] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To analyze postoperative complications after laparoscopic radical cystectomy (LRC) and evaluate its risk factors in a large prospective cohort built by the ESUT across European centers involved in minimally invasive urology in the last decade. METHODS Patients were prospectively enrolled, and data were retrospectively analyzed. Only oncologic cases were included. There were no formal contraindications for LRC: Also patients with locally advanced tumors (pT4a), serious comorbidities, and previous major abdominal surgery were enrolled. All procedures were performed via a standard laparoscopic approach, with no robotic assistance. Early and late postoperative complications were graded according to the modified Clavien-Dindo classification. Multivariate logistic regression was performed to explore possible risk factors for developing complications. RESULTS A total of 548 patients were available for final analysis, of which 258 (47%) experienced early complications during the first 90 days after LRC. Infectious, gastrointestinal, and genitourinary were, respectively, the most frequent systems involved. Postoperative ileus occurred in 51/548 (9.3%) patients. A total of 65/548 (12%) patients underwent surgical re-operation, and 10/548 (2%) patients died in the early postoperative period. Increased BMI (p = 0.024), blood loss (p = 0.021), and neoadjuvant treatment (p = 0.016) were significantly associated with a greater overall risk of experiencing complications on multivariate logistic regression. Long-term complications were documented in 64/548 (12%), and involved mainly stenosis of the uretero-ileal anastomosis or incisional hernias. CONCLUSIONS In this multicenter, prospective, large database, LRC appears to be a safe but morbid procedure. Standardized complication reporting should be encouraged to evaluate objectively a surgical procedure and permit comparison across studies.
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Affiliation(s)
- Simone Albisinni
- Department of Urology, Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium. .,Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium.
| | - Marco Oderda
- Department of Urology, Clinique Saint Augustin, Bordeaux, France
| | - Laurent Fossion
- Department of Urology, Maxima Medisch Centrum, Eindhoven, The Netherlands
| | - Virginia Varca
- Department of Urology, Ospedale Luigi Sacco, Milan, Italy
| | | | | | - Piotr Chlosta
- Department of Urology, Jagiellonian University, Kraków, Poland
| | | | | | - Thierry Piechaud
- Department of Urology, Clinique Saint Augustin, Bordeaux, France
| | - Peter Rimington
- Department of Urology, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | | | | | | | - Dogu Teber
- Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Roland Van Velthoven
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Boulevard de Waterloo 121, Brussels, Belgium
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Albisinni S, Rassweiler J, Abbou CC, Cathelineau X, Chlosta P, Fossion L, Gaboardi F, Rimington P, Salomon L, Sanchez-Salas R, Stolzenburg JU, Teber D, van Velthoven R. Long-term analysis of oncological outcomes after laparoscopic radical cystectomy in Europe: results from a multicentre study by the European Association of Urology (EAU) section of Uro-technology. BJU Int 2014; 115:937-45. [DOI: 10.1111/bju.12947] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Simone Albisinni
- Department of Urology; Hopital Erasme; Brussels Belgium
- Department of Urology; Institut Jules Bordet; Université Libre de Bruxelles; Brussels Belgium
| | | | | | | | - Piotr Chlosta
- Department of Urology; Jagiellonian University; Krakow Poland
| | - Laurent Fossion
- Department of Urology; Maxima Medisch Centrum; Eindhoven The Netherlands
| | | | - Peter Rimington
- Department of Urology; East Sussex Healthcare NHS Trust; Eastbourne UK
| | | | | | | | - Dogu Teber
- Department of Urology; University of Heidelberg; Heidelberg Germany
| | - Roland van Velthoven
- Department of Urology; Institut Jules Bordet; Université Libre de Bruxelles; Brussels Belgium
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Single-session laparoscopic cystectomy and nephroureterectomy. Wideochir Inne Tech Maloinwazyjne 2013; 8:158-61. [PMID: 23837100 PMCID: PMC3699764 DOI: 10.5114/wiitm.2011.31946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/08/2012] [Accepted: 09/24/2012] [Indexed: 11/17/2022] Open
Abstract
Patients with high grade and/or muscle invasive bladder cancer and with concomitant diseases of the upper urinary tract, e.g. urothelial tumors (transitional cell carcinoma - TCC) or afunctional hydronephrotic kidneys, may be candidates for simultaneous cystectomy and nephroureterectomy. Although the progress in laparoscopic techniques made these procedures feasible and safe, they are still technically demanding so only experienced surgeons can perform them. The aim of the study is to report our experience with laparoscopic simultaneous en bloc resection of the urinary bladder together with unilateral or bilateral nephroureterectomy in patients with TCC. Our material consists of three cases operated on in three centers between 2002 and 2011. After having completed bilateral (1 case) or unilateral (2 cases) nephroureterectomy, we performed radical cystectomy with pelvic lymph node dissection. All the specimens, including the kidneys, ureters, bladder, and reproductive organs in the female, were collected in endobags and were retrieved en bloc using hypogastric incision in the male patient and the vaginal route in the female patients. The demographic and perioperative information was collected and analyzed. All procedures were completed laparoscopically without the need of conversion to open surgery. No major intra- or postoperative complications were observed. Only 1 patient suffered from prolonged lymphatic leakage. From our experience we can conclude that single-session laparoscopic cystectomy and nephroureterectomy are technically feasible and safe, and may be offered for the treatment of selected cases of TCC of the urinary tract.
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