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Abstract
Background: Radical cystectomy is considered a “gold standard” procedure to treat invasive bladder
cancer. Orthotopic ileal neobladder after cystectomy as well as lymphadenectomy, which avoids metastasis
and enhances postoperative 5 - years survival rate are important. Moreover, the quality of life after this kind
of surgery is a great concern.
Purpose: Evaluating results of treatment of invasive bladder cancer by prostate sparing radical
cystectomy with extended pelvic lymphadenectomy and orthotopic ileal neobladder.
Material and Method: Prospective and descriptive clinical study without a control group in 43 males
who were diagnosed with invasive bladder cancer (cT2a - T4aN0
M0
), they underwent prostate sparing
radical cystectomy with extended pelvic lymphadenectomy and orthotopic ileal neobladder, from 1/2015
to12/2020 at Department of General Surgery, Hue Central Hospital.
Results: The operative time: 213,5 ± 29,7 min. The estimated blood loss: 130 ± 90 ml. The mean
number of lympho nodes which is conducted lymphadenectomy: 11,5 ± 4,5. The length of hospital stay:
17,12 ± 6,45 days. Early complication rate: 32,6%. The majority of patients who were discharged from
the hospital passed urine with urinary incontinence, weak urine stream and voided volume < 150ml. The
volume of the neobladder increased with statistical significance through follow - up examinations (p < 0,05).
The daytime continence rate was 97,2% after 6 months. 1/43 case recured at cystourethral anastomosis
after 4 months. 7 cases dead due to cancer progression.
Conclusion: Prostate sparing radical cystectomy with extended pelvic lymphadenectomy and
Hautmann - Studer orthotopic ileal neobladderstill thoroughly solve oncologic issues, reduce the possibility
of lymph node metastasis recurrence. The patient still has the sexual ability and urinary continence after
this procedure.
References
V.G. P, W.K. O, M.D. G. Treatment of muscle‐
invasive and advanced bladder cancer in 2020.
CA: a cancer journal for clinicians. 2020. 70:
-423.
T. H, T. Z, N. A, S.C. S, M.M. H, M.K. T, et al.
Evaluation of computed tomography for lymph
node staging in bladder cancer prior to radical
cystectomy. Urologia internationalis. 2016. 96:
-56.
J.A. W, T. L, E.M. C, N.C. C, M. DS, H.M. B,
et al. Updated 2016 EAU guidelines on muscle
invasive and metastatic bladder cancer. European
urology. 2017. 71: 462-475.
R.P. D, S. D, M.S. E, S. C, J. C, G. M, et al.
Lymph node dissection technique is more
important than lymph node count in identifying
nodal metastases in radical cystectomy patients:
a comparative mapping study. European urology.
60: 946-952.
V. A, J. K, M.M. W, B.R. K. Quality of life in
long ‐ term survivors of bladder cancer. Cancer.
106: 2355-2362.
C.S. V, E.E.F. vdP, J.. P-R, E. vW, L.S. M, B.W.G.
vR, et al. Prostate sparing cystectomy for bladder
cancer: A two-center study. European Journal of
Surgical Oncology. 2018. 44: 1446-1452.
H. A, E.C. S, V. S-C, G. M, J. C, D.F. P, et al.
Urinary functional outcome following radical
cystoprostatectomy and ileal neobladder
reconstruction in male patients. The Journal of
urology. 2013. 189: 1782-1788.
Tùng HV, Khánh TN, Hùng PN, Vinh LL, Khánh
LĐ. Phẫu thuật tạo hình bàng quang từ đoạn hồi
tràng theo phương pháp Studer cải tiến: Kinh
nghiệm 25 trường hợp. Tạp chí Y học Việt Nam.
S 2 - tháng 11: 485-491.
A.A. S, M. AL, A. M, H. G, I. E, B. AED, et
al. A randomized study comparing an antireflux
system with a direct ureteric anastomosis in
patients with orthotopic ileal neobladders. BJU
international. 2006. 97: 1057-1062.
A. M, A. D, R. K. Technical steps of open radical
cystectomy and orthotopic neobladder to achieve
the goals of “minimally invasive surgery”?
Indian journal of urology: IJU: journal of the
Urological Society of India. 2010. 26: 457.
Y. L, H. D, C. L, J. Z. Comparative analysis of
the clinical effect and safety of Laparoscopic
Radical Cystectomy Orthotopic Ileal Neobladder
and Open Surgery. Pakistan Journal of Medical
Sciences. 2021. 37: 59.
V. T, M. R, B. C, G. V, J. G, P. C, et al.
Orthotopic neobladder reconstruction for
bladder cancer: robotic - assisted versus open -
radical cystectomy for perioperative outcomes,
functional results and quality of life. Progres en
Urologie: Journal de L’association Francaise
D’urologie et de la Societe Francaise D’urologie.
29: 440-448.
Oánh ĐQ. Vai trò của nạo hạch trong cắt bàng
quang tận gc. Y học TP Hồ Chí Minh. 2011. S
- Tập 15: 4-8.
M. B, D.Y. J, J.P. S. Lymphadenectomy in bladder
cancer: a review. Urologia internationalis. 2007.
: 191-199.
B.H B, H.W. H, V.E. R. Impact of separate
versus en bloc pelvic lymph node dissection
on the number of lymph nodes retrieved in
cystectomy specimens. The Journal of urology.
166: 2295-2296.
J. L, R. H, J.W. T, H.K. W. Lymphadenectomy
in patients with transitional cell carcinoma of
the urinary bladder; significance for staging and
prognosis. BJU international. 2000. 85: 817-823.
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