Early functional and oncological outcomes of lateral prostate capsule sparing robot-assisted radical cystectomy-Orthotopic ileal neobladder
10.3760/cma.j.cn112330-20210422-00220
- VernacularTitle:保留前列腺侧包膜的机器人辅助根治性膀胱切除-原位回肠新膀胱术的早期疗效
- Author:
Tianxin LIN
1
;
Jibiao LI
;
Wang HE
;
Hao LIU
;
Kewei XU
;
Wen DONG
;
Hai HUANG
;
Wenlian XIE
;
Jian HUANG
Author Information
1. 中山大学孙逸仙纪念医院泌尿外科 广东省恶性肿瘤表观遗传与基因调控重点实验室广东省泌尿系统疾病临床医学研究中心，广州 510120
- Keywords:
Urinary bladder neoplasms;
Orthotopic ileal neobladder;
Robot-assisted surgery;
Prostate capsule;
Functional outcomes
- From:
Chinese Journal of Urology
2021;42(7):491-496
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the experience and results of the modified lateral prostate capsule sparing robot-assisted radical cystectomy-orthotopic ileal neobladder (LPCS-RARC-OIN).Methods:From December 2018 to November 2020, 19 patients received LPCS-RARC-OIN by a single surgeon in Sun Yat-sen Memorial Hospital, Sun Yat-sen University. LPCS-RARC-OIN was performed on male patients with high-risk non-muscle-invasive bladder cancer or muscle-invasive bladder cancer cT 2N 0M 0 without tumour in the bladder neck or urethra, and prostate cancer was ruled out by MRI and serum PSA<2.5ng/ml. The average age was 57.6 years, the average IIEF-5 score was 20.4. Separating the prostatic adenoma and the lateral prostate capsule from the base to the apex of the prostate, and retaining the lateral prostate surgical capsule or lateral prostate capsule about 1-2mm thickness. Patients were followed up and urinary function, sexual function and oncological outcomes were recorded. Results:All 19 operations were finished successfully. The average operation time was 279.9 (225-345) min and average estimated blood loss was 88.9 (30-200) ml. The average postoperative hospital stays was 15.8 (9 -23) days. The average lymph node yields was 23.3 (11-42). All surgical margins were negative and no incidental prostate cancer was found. 2 weeks, 1 month, 3 months and 6 months after catheter removal, the daytime and nighttime continence were 42.1% (8/19)and 36.8% (7/19), 63.2% (12/19)and 63.2% (12/19), 78.9% (15/19) and 73.7% (14/19), 94.7% (18/19) and 89.5% (17/19), respectively. 3 months and 6 months after operation, the average IIEF-5 score was 7.2 and 10.1 points respectively. The average follow-up was 10.6 months (5.4-26.1 months)and no recurrence or distant metastasis was found in this study.Conclusions:LPCS-RARC-OIN could improve the urinary and sexual function in selected patients. However, the long-term follow up is needed for functional and oncological outcomes.
