Graduate School, Guangxi University of Chinese Medicine, Nanning, China.
Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China.
Urol Int. 2024;108(3):242-253. doi: 10.1159/000535032. Epub 2023 Nov 27.
Laparoscopic radical cystectomy (LRC) with ileal orthotopic neobladder (IONB) reconstruction is one of the most promising methods for bladder cancer treatment; its advantages include a small incision size, less blood loss, improved perioperative outcome and tumor prognosis, and a positive self-image postoperatively. The short-term benefits of various IONB reconstruction procedures reported thus far include a simple process, short operative time, less intraoperative bleeding, few postoperative complications, and good postoperative neobladder function; in the long term, these benefits engender good quality of life of the patients. Here, we explored and summarized the more novel and available IONB reconstruction procedures to identify the safest, most efficient, and simplest IONB reconstruction techniques for patients with bladder cancer.
LRC with IONB reconstruction is technically feasible; however, most of the relevant studies have been short, employing a small sample size and a retrospective design. However, long-term, large-scale, prospective studies identifying the most appropriate bowel segments for IONB reconstruction, comparing intracorporeal and extracorporeal IONB reconstruction, assessing currently available IONBs, and resolving relevant postoperative complications further, with a focus on patients with bladder cancer, are warranted.
Several procedures for LRC with IONB reconstruction have been reported thus far. However, there is no consensus regarding the IONB reconstruction procedures most beneficial to patients with bladder cancer. Our review may aid researchers in developing a simple, safe, and efficient LRC with IONB reconstruction procedure for patients with bladder cancer.
腹腔镜根治性膀胱切除术(LRC)联合回肠原位新膀胱(IONB)重建术是治疗膀胱癌最有前途的方法之一;其优点包括切口小、出血量少、改善围手术期结果和肿瘤预后,以及术后自我形象良好。迄今为止,各种 IONB 重建术的短期益处包括手术过程简单、手术时间短、术中出血少、术后并发症少、新膀胱功能良好;从长远来看,这些益处会提高患者的生活质量。在这里,我们探讨和总结了一些更新颖、更可行的 IONB 重建术式,以确定膀胱癌患者最安全、最有效、最简单的 IONB 重建技术。
LRC 联合 IONB 重建术在技术上是可行的;然而,大多数相关研究都很短,样本量小,采用回顾性设计。然而,需要进一步开展长期、大规模、前瞻性研究,确定最适合 IONB 重建的肠段,比较腔内和腔外 IONB 重建,评估目前可用的 IONB,并解决相关的术后并发症,重点关注膀胱癌患者。
迄今为止,已经报道了几种 LRC 联合 IONB 重建术式。然而,对于哪种 IONB 重建术式最有益于膀胱癌患者,尚无共识。我们的综述可能有助于研究人员为膀胱癌患者开发一种简单、安全、有效的 LRC 联合 IONB 重建术式。