Effects of visceral fat thickness on the operation time and postoperative complications of different types of Bricker surgery
10.3969/j.issn.1009-8291.2025.10.010
- VernacularTitle:内脏脂肪厚度对不同方式膀胱全切回肠膀胱术手术时长及术后并发症的影响
- Author:
Fangming LIU
1
;
Yinong NIU
1
Author Information
1. 首都医科大学附属北京友谊医院泌尿外科,北京市卫生健康委员会泌尿外科研究所,北京 100050
- Publication Type:Journal Article
- Keywords:
Bricker surgery;
bladder cancer;
visceral fat;
postoperative complication;
open surgery;
laparoscopic surgery;
robot-assisted laparoscopic surgery;
operation time
- From:
Journal of Modern Urology
2025;30(10):869-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effects of visceral fat thickness on the operation time,intraoperative bleeding,postoperative recovery and complications of open surgery,laparoscopic surgery and robot-assisted laparoscopic total cystectomy with ileal conduit(Bricker surgery).Methods The clinical data of 373 patients with bladder malignancy undergoing Bricker surgery in Beijing Friendship Hospital and Shanghai Renji Hospital during Jan.2015 and Jul.2025 were retrospectively analyzed.The patients were divided into three groups based on the surgical approaches:open surgery group(n=120),laparoscopic surgery group(n=139),and robot-assisted laparoscopic surgery group(RLS group,n=114).The patients were further divided into group A(with visceral fat thickness＜5.06 cm)and group B(with visceral fat thickness ≥ 5.06 cm)based on preoperation CT results.The parameters were statistically analyzed and collected,including age,gender,underlying diseases,operation time,intraoperative blood loss,blood transfusion,postoperative exhaustion time,hospital stay and postoperative complications.Results In patients undergoing open surgery and Bricker surgery,the operative time for group B was(264.00±68.11)min and(310.06±42.81)min,respectively,longer than that of group A.The intraoperative blood loss was(482.46±192.84)mL and(392.54±147.00)mL,respectively,also more than that of group A(P＜0.05).The incidence of severe complications such as postoperative wound infection,urinary fistula,and bleeding in group B was 22.8％and 16.4％,respectively,significantly higher than that of group A(P＜0.05).In the open surgery group,although the postoperative recovery time of gastrointestinal function of group B was similar to that of group A,the average postoperative hospital stay was(22.91±13.09)d,which was significantly longer than that of group A[(18.95±4.42)d,P＜0.05].For group B,RLS could significantly reduce the intraoperative blood loss compared to open surgery and traditional laparoscopic surgery,lower the incidence of severe complications,and shorten the hospital stay.Conclusion For patients with bladder cancer who are scheduled for Bricker surgery,if preoperative CT reveals thick visceral fat,RLS should be considered.This approach can effectively reduce the surgical difficulty and incidence of severe postoperative complications,and accelerate the postoperative recovery.
