Journal of Minimal Access Surgery

ORIGINAL ARTICLE
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Year : 2020  |  Volume : 16  |  Issue : 4  |  Page : 390--398

Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent?

Zhenhua Liu1, Yisen Meng1, Shaobo Li2, Wei Yu1, Jie Jin1 
1 Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, Beijing, China
2 Department of Pathology, School of Basic Medicine, Fudan University, Shanghai, China

Correspondence Address:
Prof. Wei Yu
Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, 8 Xishiku Street, Xicheng District, Beijing 100034
China
Dr Yisen Meng
Department of Urology, Peking University First Hospital and Institute of Urology, National Research Center for Genitourinary Oncology, 8 Xishiku Street, Xicheng District, Beijing 100034
China

Context: Radical cystectomy (RC) has complicated surgical procedures and various ways of urinary reconstruction. Aims: The aim of this study is to investigate whether the advantages of laparoscopy over open surgery were consistent in the perioperative recovery of different methods of urinary diversion after RC in the general and the elderly (>65 years) population. Settings and Design: A retrospective study reviewed 452 (elderly 261) patients who received RC from the year 2005–2012. Subjects and Methods: Of all, 88 patients underwent laparoscopic RC (LRC) and 364 patients underwent open RC (ORC). There were 325 patients received ileal conduit (IC), whereas 127 patients received cutaneous ureterostomy (CU). Statistical Analysis Used: We used different statistical methods (t-test, Chi-square, etc.) to compare variables outcomes. Results: For IC urinary diversion, the general patients undergoing LRC had less intra-operative blood loss (566.5 vs. 1320.3 ml, P < 0.001), lower blood transfusion rate (11.4 vs. 34.1%, P < 0.001), shorter gastrointestinal recovery time (5.7 vs. 6.7 days, P= 0.002) and shorter length of hospital stay (LOS) (21.7 vs. 26.0 days, P = 0.003) than patients receiving ORC. Similar trends were observed in older patients. For CU urinary diversion, the general and the elderly patients receiving LRC had a shorter mean time to gastrointestinal recovery (P = 0.017, P < 0.001, respectively) than patients receiving ORC. No differences were found between LRC and ORC in intra-operative blood loss, allogeneic blood transfusion rate and LOS. Conclusions: In the general and the elderly population, laparoscopic approach could result in more rapid rehabilitation for RC patients, especially in the IC patients.


How to cite this article:
Liu Z, Meng Y, Li S, Yu W, Jin J. Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent?.J Min Access Surg 2020;16:390-398


How to cite this URL:
Liu Z, Meng Y, Li S, Yu W, Jin J. Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent?. J Min Access Surg [serial online] 2020 [cited 2020 Nov 24 ];16:390-398
Available from: https://www.journalofmas.com/article.asp?issn=0972-9941;year=2020;volume=16;issue=4;spage=390;epage=398;aulast=Liu;type=0