Department of Urology, The Second Affiliated Hospital of Anhui Medical University, NO. 678 Furong Road, Hefei, 230032, China.
BMC Urol. 2021 Nov 15;21(1):159. doi: 10.1186/s12894-021-00920-6.
This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit.
Eighty-four patients, who were diagnosed with high-risk non-muscle-invasive and muscle-invasive bladder carcinoma and underwent LRC with an ileal conduit between January 2018 and April 2020, were retrospectively evaluated. Thirty and fifty-four patients respectively underwent the three-port approach and five-port LRC. Clinical characteristics, pathological data, perioperative outcomes, and follow-up data were analysed.
There were no differences in perioperatively surgical outcome, including pathology type, prostate adenocarcinoma incidence, tumour staging, and postoperative creatinine levels between the two groups. The operative time (271.3 ± 24.03 vs. 279.57 ± 48.47 min, P = 0.299), estimated blood loss (65 vs. 90 mL, P = 0.352), time to passage of flatus (8 vs. 10 days, P = 0.084), and duration of hospitalisation post-surgery (11 vs. 12 days, P = 0.922) were no clear difference between both groups. Compared with the five-port group, the three-port LRC group was related to lower inpatient costs (12 453 vs. 14 134 $, P = 0.021). Our follow-up results indicated that the rate of postoperative complications, 90-day mortality, and the oncological outcome did not show meaningful differences between these two groups.
Three-port LRC with an ileal conduit is technically safe and feasible for the treatment of bladder cancer. On comparing the three-port LRC with the five-port LRC, our technique does not increase the rate of short-term and long-term complications and tumour recurrence, but the treatment costs of the former were reduced.
本研究旨在评估三孔法与传统五孔腹腔镜根治性膀胱切除术（LRC）联合回肠导管治疗的效果。
回顾性分析 2018 年 1 月至 2020 年 4 月期间接受 LRC 联合回肠导管治疗的 84 例高危非肌层浸润性和肌层浸润性膀胱癌患者。其中 30 例患者采用三孔法，54 例患者采用五孔法。分析临床特征、病理数据、围手术期结果和随访数据。
两组患者在围手术期手术结果方面无差异，包括病理类型、前列腺腺癌发生率、肿瘤分期和术后肌酐水平。手术时间（271.3±24.03 分钟比 279.57±48.47 分钟，P=0.299）、估计失血量（65 毫升比 90 毫升，P=0.352）、肛门排气时间（8 天比 10 天，P=0.084）和术后住院时间（11 天比 12 天，P=0.922）均无明显差异。与五孔组相比，三孔 LRC 组的住院费用较低（12453 美元比 14134 美元，P=0.021）。我们的随访结果表明，两组术后并发症发生率、90 天死亡率和肿瘤学结果无显著差异。
三孔 LRC 联合回肠导管治疗膀胱癌在技术上是安全可行的。与五孔 LRC 相比，三孔技术不会增加短期和长期并发症及肿瘤复发的发生率，但前者的治疗费用降低。
