Laparoscopic radical cystectomy with extracorporeal neobladder: our initial experience.

OBJECTIVES: To illustrate our technique to construct the Institute of Urology Peking University (IUPU) orthotopic ileal bladder and present our initial experience.

METHODS: From August 2017 to April 2018, twelve patients with bladder cancer underwent radical cystectomy (RC), pelvic lymph node dissection (LND) and extracorporeal construction of an IUPU neobladder (IUPUB) by an experienced surgeon. We present the demographic, clinicopathologic, perioperative and follow-up data. We also describe our step-by-step surgical technique for the IUPUB in this article.

RESULTS: Laparoscopic RC (LRC) with an extracorporeal IUPUB was successfully accomplished in 11 patients, and one patient was converted to open radical cystectomy with an IUPUB. The median total operative time and median time spent suturing the pouch were 248 min and 23 min, respectively. The median estimated blood loss was 150 ml. The median time to recovery of bowel function (tolerance of a liquid diet) was 3.5 days. The urinary catheter was removed on postoperative day 21 in 10 patients. The ureteral stents and stoma catheter were removed on day 7 after cystography. At a median follow-up of 7.5 months, two patients had early complications (< 30 days), and no major complications (grade ≥ 3) occurred. The follow-up outcomes were satisfactory. The limitations included the small sample size and short-term outcomes.

CONCLUSION: Our technique of constructing the IUPUB is feasible and safe. The operative time and early complication rates are acceptable.