Clinical value of"four longitudinal,two transverse planes"method of membrane anatomy in laparoscopic radical cystectomy
10.3969/j.issn.1009-8291.2024.05.004
- VernacularTitle:基于膜解剖之四纵两横六层面法的腹腔镜根治性膀胱切除术的临床应用价值("大家泌尿网"观看手术视频)
- Author:
Dongping BAO
1
;
Peifeng ZHONG
;
Guohao WU
;
Haomin LI
;
Dongjiang CHEN
;
Xianguo HU
;
Bingquan WU
;
Zheng CHEN
;
Zexiong GUO
;
Dongming YE
;
Caiyong LAI
Author Information
1. 暨南大学附属第一医院泌尿外科,广东广州 510630
- Keywords:
membrane anatomy;
bladder cancer;
radical cystectomy;
"four longitudinal,two transverse planes"method
- From:
Journal of Modern Urology
2024;29(5):399-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of laparoscopic radical cystectomy based on fascia anatomy for bladder cancer treatment.Methods The clinical data of 51 patients with bladder cancer who underwent 3D laparoscopic radical cystectomy during Jan.2015 and Jun.2022 were retrospectively analyzed.The surgery was performed based on membrane anatomy technology along four longitudinal and two transverse planes to complete the radical cystectomy.The pelvic plexus was preserved for patients with normal preoperative sexual function.Results All surgeries were completed without conversion to open operation.The mean operation time was(502.52±108.99)min,mean intraoperative blood loss was(275.96±155.18)mL,mean postoperative drainage time was(4.14±2.41)d,and the mean postoperative hospital stay was(16.37±4.85)d.The mean number of lymph nodes removed was(17.98±11.48).The mean postoperative follow-up was(30.27±19.39)months.At the last follow-up,no Clavien ≥grade 3 complications were observed.The estimated overall survival(OS),tumor-specific survival(TSS),and recurrence-free survival(RFS)were 82.4％,92.2％,and 88.2％,respectively.The lymph node positive patients had shorter OS and RFS(60.0％,60.0％)than the lymph node negative patients(84.8％,91.3％).Among the 19 male patients who underwent radical cystectomy with pre-exposure and preservation of pelvic plexus,daytime and nocturnal continence rate were 83.3％and 72.2％,respectively,and 17 patients recovered potency within 6 months postoperatively.Conclusion Laparoscopic radical cystectomy based on fascia anatomy is safe and effective in laparoscopic radical cystectomy,with standardized surgical procedure,satisfactory oncological outcomes,little hemorrhage,few complications and fast recovery.
