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Huang Jian, Lin Tianxin, Xu Kewei, Huang Hai, Yao Yousheng et al Urology Department

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 2nd Affiliated Hospital ,Sun Yat-sen University, Guangzhou China. The Objectives.

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Huang Jian, Lin Tianxin, Xu Kewei, Huang Hai, Yao Yousheng et al Urology Department

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

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

  3. Patients data • 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

  4. Patient’s Position

  5. The Second Affiliated Hospital of Sun Yat-Sen University

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

  7. Pathologcal findings stage：T1 T2 T3 T4a Tis Associated cases： 7 66 33 2 3 grade：G1 G2 G3 cases： 9 75 24 LN(-): 95 LN(+): 13 TCC 102，SCC 3，AC 1，TCC+AC 2 The Second Affiliated Hospital of Sun Yat-Sen University

  8. Results • The operation time : 330min （210～600min） • The blood loss: 320ml（50～1000ml） • The daytime continence rates: 90.7% • The nighttime continence rate: 82.6% • The neobladder capacity : 343 ml (230~540ml) The Second Affiliated Hospital of Sun Yat-Sen University

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

  10. Cystourethrography The Second Affiliated Hospital of Sun Yat-Sen University

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

  12. Post-operative major complications • vesico-urethral anastomotic leakage 3 • vesico-urethral anastomotic stricture 2 • uretero-pouch anastomotic stricture 3 • Proloned Lymphatic leakage 3 • pouch-vaginal fistula 1 • ileal anastomotic leakage 1 • colon-pouch fistula 1 • ileo-pouch fistula 1 • pneumonia 1 • Pyelonephritis 1 • Ileus 3 Complication rate 18.5% The Second Affiliated Hospital of Sun Yat-Sen University

  13. Oncological outcomes • Local recurrence 5 • Trocar site seeding 1 • Distant metastasis 6 (liver 3, Lung1, bone 2) • died11 The Second Affiliated Hospital of Sun Yat-Sen University

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

  15. Ｔhanks！ The Second Affiliated Hospital of Sun Yat-Sen University

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