He Wang, Yang Jingtian, Gao Mingchao, Liu Hao, Li Jibiao, Hu Jintao, Zhang Yishan, Zhong Guangzheng, Li Kaiwen, Dong Wen, Huang Hai, Lin Tianxin, Huang Jian
Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiangxi Road, Yuexiu District, Guangzhou, 510120, Guangdong, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
Int Urol Nephrol. 2022 Jul;54(7):1537-1543. doi: 10.1007/s11255-022-03214-4. Epub 2022 May 12.
To evaluate urinary outcomes of pelvic construction and lateral capsule sparing techniques in robot-assisted radical cystectomy with orthotopic ileal neobladder (RARC-OIN).
A total of 107 male patients who underwent RARC-OIN during January 2017 and February 2021 in Sun Yat-sen Memorial Hospital were analyzed retrospectively. Standard RARC-OIN with or without nerve sparing technique was performed in 44 patients (standard group), lateral prostate capsule sparing technique was performed in 20 patients (LCS group), combined pelvic reconstruction (CPR) technique including anterior suspension and posterior reconstruction were performed in 43 patients (CPR group). The urinary function was assessed by the use of pads and the Bladder Cancer Index (BCI). Continence was defined as the use of 0-1 pad during daytime or night-time.
There was no statistical difference between the three groups regarding demographic, perioperative, and pathological data. Continence rates were 6.8, 50.0 and 34.9% for daytime, 4.6, 40.0 and 32.6% for night-time in the standard group, LCS group and CPR group at 1 month post-operation, respectively. Continence rates were 34.1, 80.0 and 69.8% for daytime, 27.3, 75.0 and 65.1% for night-time in the standard group, LCS group and CPR group at 3 month post-operation, respectively. No statistically significant difference was observed in the daytime and night-time continence rates at 12 months.
Lateral capsule-sparing and combined pelvic reconstruction techniques are feasible to improve early daytime and night-time continence rates in RARC with orthotopic neobladder.
The trial registration number: ChiCTR2100047606.
评估在机器人辅助根治性膀胱切除术并原位回肠新膀胱术（RARC - OIN）中盆腔重建和保留外侧包膜技术的尿控效果。
回顾性分析2017年1月至2021年2月在中山大学孙逸仙纪念医院接受RARC - OIN的107例男性患者。44例患者行标准RARC - OIN（无论是否采用保留神经技术）（标准组），20例患者行保留前列腺外侧包膜技术（LCS组），43例患者行包括前悬吊和后重建的联合盆腔重建（CPR）技术（CPR组）。通过使用尿垫和膀胱癌指数（BCI）评估尿控功能。尿失禁定义为白天或夜间使用0 - 1片尿垫。
三组在人口统计学、围手术期和病理数据方面无统计学差异。术后1个月时，标准组、LCS组和CPR组白天的尿控率分别为6.8%、50.0%和34.9%，夜间分别为4.6%、40.0%和32.6%。术后3个月时，标准组、LCS组和CPR组白天的尿控率分别为34.1%、80.0%和69.8%，夜间分别为27.3%、75.0%和65.1%。12个月时白天和夜间尿控率无统计学显著差异。
保留外侧包膜和联合盆腔重建技术对于提高RARC原位新膀胱术患者早期白天和夜间尿控率是可行的。
ChiCTR2100047606。
