Department of Urology, "Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Int Braz J Urol. 2019 May-Jun;45(3):560-571. doi: 10.1590/S1677-5538.IBJU.2018.0262.
To introduce our experience with intracorporeal ileal conduit and evaluate the safety and feasibility of this endoscopic urinary diversion.
Between March 2014 and July 2017, thirty-six consecutive patients underwent laparoscopic radical cystectomy with intracorporeal ileal conduit. Patients' demographic data, perioperative data, 90-days postoperative outcomes and complications were collected. This cohort were divided into two groups of 18 patients each by chronological order of the operations to facilitate comparison of clinical data. Data were evaluated using the students' T test, Mann-Whitney test and Fisher's Exact test.
All surgeries were completed successfully with no conversion. Median total operating time and median intracorporeal urinary diversion time were 304 and 105 minutes, respectively. Median estimated blood loss was 200 mL, and median lymph node yield was 21. Twenty-six Clavien grade < 3 complications occurred within 30-days and 9 occurred within 30-90 days. Five Clavien grade 3-5 complications occurred within 30 days. No statistically signifi cant differences were found between the two groups except for intracorporeal urinary diversion time. At median follow-up of 17.5 (range 3-42) months, 6 patients experienced tumor recurrence/metastasis and 4 of these patients died.
Intracorporeal ileal conduit following laparoscopic radical cystectomy is safe, feasible and reproducible. With the accumulation of experience, the operation time can be controlled at a satisfactory level.
介绍我们在体腔内回肠导管方面的经验,并评估这种内镜下尿流改道的安全性和可行性。
2014 年 3 月至 2017 年 7 月,36 例连续患者接受腹腔镜根治性膀胱切除术联合体腔内回肠导管术。收集患者的人口统计学数据、围手术期数据、90 天术后结果和并发症。本队列按手术的时间顺序分为两组,每组 18 例,以方便比较临床数据。使用学生 t 检验、Mann-Whitney 检验和 Fisher 精确检验对数据进行评估。
所有手术均顺利完成,无中转。中位总手术时间和中位体腔内尿流改道时间分别为 304 分钟和 105 分钟。中位估计出血量为 200ml,中位淋巴结产量为 21 个。30 天内发生 26 例 Clavien 分级<3 级并发症,90 天内发生 9 例。30 天内发生 5 例 Clavien 分级 3-5 级并发症。两组除体腔内尿流改道时间外,其他数据均无统计学差异。中位随访时间为 17.5 个月(范围 3-42 个月),6 例患者发生肿瘤复发/转移,其中 4 例患者死亡。
腹腔镜根治性膀胱切除术后进行体腔内回肠导管术是安全、可行且可重复的。随着经验的积累,手术时间可以控制在令人满意的水平。