Gaston Richard, Ramírez Patricia
Clinique Saint Augustin. Bordeaux. France.
Hospital Universitario Puerta de Hierro. Madrid. Spain.
Arch Esp Urol. 2019 Apr;72(3):309-317.
It is well known that RARC with intracorporeal diversion is being increasingly performed worldwide. In this article, we review the current situation of the intracorporeal neobladder.
We discuss the principles of intracorporeal orhotopic diversion, focusing on the most relevant: The Karolinska-modified Studer neobladder, the University of Southern California-modified Studer neobladder. The pyramid pouch and the modified Y-shaped orthotopic neobladder. We also compare functional and perioperative outcomes from our series and the available studies regarding RARC and intracorporeal orthotopic diversion. RESULTS: Review of existing literature suggests that RARC with totally intracorporeal neobladder, in some cases, has improved operative, postoperative, and functional outcomes, becoming a safe and feasible alternative to ORC.
The results from the intraorporeal neobladders series appear to be promising, but high-quality randomized controlled trials comparing to ICUD to ECUD should be performed in order to define the advantages and disadvantages of totally intracorporeal urinary diversion and its future role in the treatment of invasive bladder cancer.
众所周知，全球范围内采用体内改道的机器人辅助根治性膀胱切除术（RARC）的开展越来越多。在本文中，我们回顾了体内新膀胱的现状。
我们讨论了体内原位改道的原则，重点介绍了最相关的术式：卡罗林斯卡改良斯图德新膀胱、南加州大学改良斯图德新膀胱、金字塔形贮尿囊和改良Y形原位新膀胱。我们还比较了我们系列研究以及关于RARC和体内原位改道的现有研究的功能和围手术期结果。
对现有文献的回顾表明，在某些情况下，采用完全体内新膀胱的RARC改善了手术、术后和功能结果，成为开放性根治性膀胱切除术（ORC）的一种安全可行的替代方案。
体内新膀胱系列研究的结果似乎很有前景，但应开展高质量的随机对照试验，将体内尿流改道术（ICUD）与体外尿流改道术（ECUD）进行比较，以明确完全体内尿流改道的优缺点及其在浸润性膀胱癌治疗中的未来作用。
