Radical cystectomy with extended lymphadenectomy in the presence of a pelvic kidney

Feasibility of robot‑assisted radical cystectomy in a patient with an ectopic kidney: A case report

An ectopic kidney is a rare congenital defect in which the kidney does not migrate to its normal anatomical position. In the present study, a robot-assisted radical cystectomy and intracorporeal urinary diversion were performed for a patient with an ectopic kidney. The present study describes the case of a 72-year-old male patient who was diagnosed with a bladder tumor by magnetic resonance imaging and cystoscopy. A transurethral resection of the bladder tumor was performed. The pathological examination revealed an invasive urothelial carcinoma. Contrast-enhanced computed tomography revealed an ectopic left kidney in the upper pelvis. A robot-assisted radical cystectomy, extended lymph node dissection and intracorporeal urinary diversion were performed. On the whole, as demonstrated herein, a robot-assisted radical cystectomy with intracorporeal urinary diversion is a feasible approach for muscle-invasive bladder cancer complicated by an ectopic kidney.

Radical cystectomy and lymphadenectomy to two patients with pelvic kidney: surgical pitfalls and considerations

Our goal is to describe our experience in the difficulties encountered during radical cystectomy for muscle invasive bladder cancer in patients with contemporary pelvic kidney. Two patients with muscle invasive bladder cancer and contemporary pelvic kidney were subjected to radical cystectomy and extended lymphadenectomy with conversion to an ileal pouch. In both cases, lymphadenectomy was the first step after entering the true pelvis. In order to proceed to the cystoprostatectomy, careful dissection of the ectopic renal vessels and proper mobilization of the kidney were performed. In both cases, an ileal pouch was our choice. The pelvic kidney is the most common sight of renal ectopia. The etiology is the aborted ascent of the fetal kidney from its initial position in the pelvis. This is the first case series describing radical cystectomy for muscle invasive urothelial carcinoma of the bladder in patients with a pelvic kidney.

Ileal conduit post radical cystectomy: modifications of the technique

INTRODUCTION

Ileal conduit, post radical cystectomy, is currently the most practiced type of urinary diversion. The aim of our study was to modify the ileal conduit technique in order to retain acceptable outcomes while decreasing the rate of postoperative urine leak and ureteroileal stricture.

METHODS

Forty consecutive patients were included in our study, from January to June 2011. Radical cystectomy and ileal conduit using our modifications were done for all the cases. Follow-up was done for one year. One patient with right pelvic kidney was added to the studied group and was managed by extra modification to our technique.

RESULTS

The mean age of the patients was 63 years. No significant leak and no stricture were observed within the modest duration of follow-up. When a left upper urinary tract retrograde study was attempted in one patient, the left ureteric orifice could not be reached due to a redundant elongated ileum.

CONCLUSIONS

Modified Bricker techniques are safe, avoid early postoperative urine leak, and lower the incidence of ureteroileal anastomotic stricture. Using our modifications, retrograde access of the left ureter may not be possible. The 'Z' ileal conduit is a feasible technique that can allow tension-free healthy ureteroileal anastomosis for cases with pelvic right kidney and, probably, post renal transplantation.

Fallopian tube carcinoma in a patient with a pelvic kidney: surgical management with the da Vinci robot

A patient with a known pelvic kidney and early fallopian tube carcinoma was managed with robotically assisted surgery. Associated conginital anomalies were noted and described. The final stage of the cancer was 1C, grade 3 and she is without evidence of recurrent cancer 2 years following completion of chemotherapy.

Postradical cystectomy bowel perforation caused by a drainage tube: a case report

Introduction

Open drains are frequently placed in the abdominal cavity to prevent the collection of fluid or blood following major surgery.

Case presentation

We describe a case of perforation of the large bowel caused by the drain tube placed in a 74-year-old patient who had undergone radical cystectomy for invasive bladder cancer.