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Published on: March 24, 2023
Laparoscopic radical cystectomy: an Italian survey
M C Sighinolfi1, S Micali, A Celia
1Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100, Modena, Italy. sighinolfic@yahoo.com
Surgical Endoscopy
|February 8, 2007
Summary
Laparoscopic radical cystectomy (LRC) is a complex but feasible procedure for muscle-invasive bladder cancer. While technically demanding, experience can reduce morbidity, with bowel management and reconstruction being key challenges.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Radical cystectomy with urinary diversion is the standard for muscle-invasive bladder cancer.
- Laparoscopic radical cystectomy (LRC) has advanced globally, despite its complexity in both cancer removal and reconstruction.
Purpose of the Study:
- To assess the Italian experience with LRC and urinary diversion.
- To determine the volume of LRC procedures in Italy and provide surgical details.
Main Methods:
- A survey was sent to 10 Italian urologic departments specializing in laparoscopic surgery.
- Five departments participated, reporting on indications, technique, complications, and follow-up for 83 LRC procedures.
Main Results:
- The mean operative time was 8 hours 40 minutes with 376 ml estimated blood loss.
- Complications included one urinary leakage, one fistula, and one atrium rupture; two cases required conversion to open surgery.
- Urinary diversions included 43 ileal conduits and 26 orthotopic diversions, with a mean follow-up of 9 months and no tumor seeding.
Conclusions:
- Laparoscopic radical cystectomy is feasible but technically challenging.
- Morbidity associated with LRC may decrease with increased surgical experience.
- Bowel management and reconstruction present the most significant challenges in LRC.