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Abdallah A, Abdel-Hakiem M, El-Feel A. Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion: Technique, feasibility, and the 3-year follow-up. Arab J Urol. 2014;12(3):229-33doi: 10.1016/j.aju.2014.05.003.
Abdallah, A., Abdel-Hakiem, M., & El-Feel, A. (2014). Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion: Technique, feasibility, and the 3-year follow-up. Arab journal of urology, 12(3), 229-33. https://doi.org/10.1016/j.aju.2014.05.003
Abdallah, Ahmed, et al. "Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion: Technique, feasibility, and the 3-year follow-up." Arab journal of urology vol. 12,3 (2014): 229-33. doi: https://doi.org/10.1016/j.aju.2014.05.003
Abdallah A, Abdel-Hakiem M, El-Feel A. Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion: Technique, feasibility, and the 3-year follow-up. Arab J Urol. 2014 Sep;12(3):229-33. doi: 10.1016/j.aju.2014.05.003. Epub 2014 Jun 11. PMID: 26019955; PMCID: PMC4435925.
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Arab J Urol. 2014 Sep;12(3):229-33. doi: 10.1016/j.aju.2014.05.003. Epub 2014 Jun 11.

Laparo-endoscopic single-site radical cystectomy with orthotopic urinary diversion: Technique, feasibility, and the 3-year follow-up.

Arab journal of urology

Ahmed Abdallah, Mahmoud Abdel-Hakiem, Ahmed El-Feel

Affiliations

  1. Department of Urology, Cairo University, Cairo, Egypt.

PMID: 26019955 PMCID: PMC4435925 DOI: 10.1016/j.aju.2014.05.003

Abstract

OBJECTIVES: To assess the feasibility, operative morbidity and oncological outcome of laparoendoscopic single-site (LESS) radical cystectomy.

PATIENTS AND METHODS: Ten patients with clinical stage T1-T2 bladder cancer underwent a LESS radical cystectomy. The mean (SD) age of the patients was 64.8 (8.6) years and their mean body mass index was 25.9 (2.7) kg/m(2). The procedure was done via a single-incision laparoscopic surgery port using a rigid 5-mm 30° long-shaft laparoscope in addition to the two working instruments. A 7-cm Pfannenstiel incision was made to remove the specimens and to allow the creation of an ileal neobladder with hand assistance.

RESULTS: In eight patients the LESS radical cystectomy was completed as scheduled, with the other two requiring a conversion, one to an open procedure due to locally advanced disease, and the other to conventional laparoscopy due to gas leakage. The mean (SD) operative duration was 236 (49) min, with a mean estimated blood loss of 575 (113) mL, and a mean hospital stay of 5.5 (0.7) days. No postoperative analgesic medications were prescribed and patients returned to normal activity after a mean (SD) of 17.6 (2.6) days. The pathological examination showed negative surgical margins for the bladder specimens, with a mean (SD) of 14 (1.9) lymph nodes retrieved. Seven patients were cancer-free within a mean (SD, range) follow-up of 37 (6, 29-44) months.

CONCLUSIONS: LESS radical cystectomy is technically feasible, with a favourable course and convalescence, and it has an acceptable oncological outcome.

Keywords: ASA, American Society of Anesthesiologists; BMI, body mass index; Bladder cancer; LESS; LESS, laparo-endoscopic single-site; RC, radical cystectomy; Radical cystectomy; SILS, single-incision laparoscopic surgery

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