Perioperative and oncological outcomes of laparoscopic radical cystectomy with intracorporeal versus extracorporeal ileal conduit: A matched‐pair comparison in a multicenter cohort in Japan
| Autor: | Mutsushi Kawakita, Masato Fujii, Toshiya Akao, Atsuro Sawada, Seiji Moroi, Junji Yatsuda, Kazuhiro Okumura, Ryoichi Saito, Katsuhiro Ito, Osamu Ogawa, Takahiro Inoue, Yosuke Shimizu, Go Kobori, Takashi Kobayashi, Hitoshi Yamada, Masashi Kubota, Toru Kanno, Yasumasa Shichiri |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment 030232 urology & nephrology Urinary Diversion Cystectomy Ileal conduit urinary diversion Extracorporeal 03 medical and health sciences 0302 clinical medicine Japan medicine Humans Laparoscopy Retrospective Studies Bladder cancer medicine.diagnostic_test business.industry digestive oral and skin physiology Postoperative complication Perioperative respiratory system medicine.disease Surgery Treatment Outcome Urinary Bladder Neoplasms 030220 oncology & carcinogenesis cardiovascular system Neoplasm Recurrence Local Complication business human activities |
| Zdroj: | International Journal of Urology. 27:559-565 |
| ISSN: | 1442-2042 0919-8172 |
| DOI: | 10.1111/iju.14245 |
| Popis: | Objectives To compare the perioperative and oncological outcomes of pure laparoscopic intracorporeal ileal conduit urinary diversion versus extracorporeal ileal conduit urinary diversion after laparoscopic radical cystectomy for bladder cancer in a multicenter cohort in Japan. Method A total of 455 patients who underwent laparoscopic radical cystectomy carried out at 10 institutions were included in this retrospective study. The perioperative data of the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups were compared using the propensity score matching method. The Kaplan-Meier curves were obtained to elucidate time to ureteroenteric stricture, reoperation, recurrence and survival. Results In total, 72 matched pairs were evaluated for the final analysis. The median follow-up period was 28 and 23 months in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively. The operative time in the intracorporeal ileal conduit urinary diversion group was approximately 1 h longer than that in the extracorporeal ileal conduit urinary diversion group. The early and late postoperative complication rates were similar in both groups, except for the reduced wound-related complication rates in the intracorporeal ileal conduit urinary diversion group. The median days to regular oral food intake were 4 and 5 days in the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups, respectively (P = 0.014). No significant difference was noted in the occurrence of ureteroenteric strictures and reoperation rate. Furthermore, recurrence-free, cancer-specific, and overall survival rates and recurrence patterns did not significantly differ. Conclusions Laparoscopic intracorporeal ileal conduit urinary diversion is a safe, feasible and reproducible procedure with similar postoperative complication rates, ureteroenteric stricture rate and oncological outcomes when compared with extracorporeal ileal conduit urinary diversion, but faster postoperative bowel recovery and decreased wound-related complication rates. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|