Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Urology, Jiangmen Central Hospital, Jiangmen, China.
Eur Urol. 2021 Apr;79(4):545-551. doi: 10.1016/j.eururo.2020.10.035. Epub 2020 Nov 14.
Intracorporeal urinary diversion is considered to be effective in improving intestinal function recovery and reducing the occurrence of early complications after radical cystectomy. Almost all neobladders constructed via intracorporeal laparoscopy have used the ileum.
To present our intracorporeal detaenial sigmoid neobladder technique that replicates open surgery principles and to present oncological and functional outcomes and complication rates.
DESIGN, SETTING, AND PARTICIPANTS: This is a case series from a single tertiary referral hospital from September 11, 2018 to April 19, 2019, including 12 selected patients with pathologically confirmed muscle-invasive or refractory non-muscle-invasive bladder cancer.
Laparoscopic radical cystectomy including pelvic lymph-node dissection and intracorporeal detaenial sigmoid neobladder, which is demonstrated in the accompanying video.
Demographic, clinical, and pathological data were collected. Perioperative outcomes and 1-yr oncological and functional outcomes are reported.
All surgeries were successful without severe complications or conversion to open surgery. The mean operative time (± standard deviation) was 414.6 ± 52.2 min, with 33.8 ± 6.80 min for neobladder construction. Surgical margins and lymph nodes were all negative for metastasis. All patients were encouraged to do ambulation exercise 1 d after surgery, and oral liquid intake was resumed between days 2 and 4. However, because this was a retrospective study in a single centre with very few cases, it is difficult to reach a definitive conclusion.
Intracorporeal detaenial sigmoid neobladder is technically feasible with no need for additional medical equipment. Encouraging outcomes were observed during short-term follow-up. This approach could represent another alternative choice for patients undergoing laparoscopic radical cystectomy. Longer-term follow-up data are needed to evaluate oncological and functional outcomes.
We describe our stepwise technique for intracorporeal detaenial sigmoid neobladder while replicating established open surgery principles. In addition to retaining the advantages of a neobladder, better postoperative recovery is achieved.
腔内尿路分流被认为能有效改善肠道功能恢复，减少根治性膀胱切除术后早期并发症的发生。几乎所有通过腔内腹腔镜构建的新膀胱都使用了回肠。
介绍我们的腔内Detanial 乙状结肠新膀胱技术，该技术复制了开放手术原则，并介绍了肿瘤学和功能结果以及并发症发生率。
设计、地点和参与者：这是 2018 年 9 月 11 日至 2019 年 4 月 19 日期间来自一家单一的三级转诊医院的病例系列研究，包括 12 名经病理证实为肌层浸润性或难治性非肌层浸润性膀胱癌的选定患者。
腹腔镜根治性膀胱切除术，包括盆腔淋巴结清扫术和腔内 Detanial 乙状结肠新膀胱，手术过程在随附的视频中演示。
收集人口统计学、临床和病理数据。报告围手术期结果和 1 年肿瘤学和功能结果。
所有手术均成功完成，无严重并发症或转为开放手术。平均手术时间（±标准差）为 414.6±52.2 分钟，新膀胱构建时间为 33.8±6.80 分钟。手术切缘和淋巴结均无转移。所有患者术后第 1 天鼓励下床活动，术后第 2-4 天开始口服液体。然而，由于这是一项在单个中心进行的回顾性研究，且病例很少，因此很难得出明确的结论。
腔内 Detanial 乙状结肠新膀胱技术具有可行性，无需额外的医疗设备。在短期随访中观察到令人鼓舞的结果。对于接受腹腔镜根治性膀胱切除术的患者，这种方法可能是另一种选择。需要更长时间的随访数据来评估肿瘤学和功能结果。
我们描述了我们的腔内 Detanial 乙状结肠新膀胱分步技术，同时复制了既定的开放手术原则。除了保留新膀胱的优势外，还能实现更好的术后恢复。
