Laparoscopic Radical Cystectomy with Orthotopic Ileal Neobladder Sun

Laparoscopic Radical Cystectomy with Orthotopic Ileal Neobladder: Sun Yat Sen University Experience Huang Jian, Lin Tianxin, Xu Kewei, Huang Hai, Yao Yousheng et al Urology Department The 2 nd Affiliated Hospital , Sun Yat-sen University, Guangzhou China The Second Affiliated Hospital of Sun Yat-Sen University

The Objectives n Laparoscopic radical cystectomy is more and more accepted by doctors and patients. n Standard operation procedure has not yet been established. n Report our technique improvements of LRC and early results. The Second Affiliated Hospital of Sun Yat-Sen University

Patients data Ø Ø From Dec. 2002 to May 2007 108 cases (96 male, 12 female) All with bladder cancer Follow up: 28 months(1~53 months) The Second Affiliated Hospital of Sun Yat-Sen University

Patient’s Position

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Surgical Procedures: The Second Affiliated Hospital of Sun Yat-Sen University

Pathologcal findings stage：T 1 cases： 7 T 2 T 3 66 33 grade：G 1 cases： 9 G 2 75 LN(-): 95 LN(+): 13 T 4 a Tis Associated 2 3 G 3 24 TCC 102，SCC 3，AC 1，TCC+AC 2 The Second Affiliated Hospital of Sun Yat-Sen University

Results n The operation time : 330 min （210～ 600 min） n The blood loss: 320 ml（50～ 1000 ml） n The daytime continence rates: 90. 7% n The nighttime continence rate: 82. 6% n The neobladder capacity : 343 ml (230~540 ml) The Second Affiliated Hospital of Sun Yat-Sen University

Postoperative IVU The Second Affiliated Hospital of Sun Yat-Sen University

Cystourethrography The Second Affiliated Hospital of Sun Yat-Sen University

Small ureteral nipple in cystoscopy The Second Affiliated Hospital of Sun Yat-Sen University

Post-operative major complications vesico-urethral anastomotic leakage p vesico-urethral anastomotic stricture p uretero-pouch anastomotic stricture p Proloned Lymphatic leakage p pouch-vaginal fistula p ileal anastomotic leakage p colon-pouch fistula p ileo-pouch fistula p pneumonia p Pyelonephritis p Ileus Complication rate 18. 5% p 3 2 3 3 1 1 1 3 The Second Affiliated Hospital of Sun Yat-Sen University

Oncological outcomes n Local recurrence 5 n Trocar site seeding 1 n Distant metastasis 6 (liver 3, Lung 1, bone 2) n died 11 The Second Affiliated Hospital of Sun Yat-Sen University

Conclusions n Laparoscopic radical cystectomy with extracorporeal formation of neobladder is a feasible procedure with low morbidity and acceptable neobladder function. n Long term follow-up is needed to confirm the oncological outcomes. The Second Affiliated Hospital of Sun Yat-Sen University

The Second Affiliated Hospital of Sun Yat-Sen University