Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection

Abstract

Background & Aims: In patients with recurrent high grade or muscle invasive bladder cancer and concomitant upper urinary tract tumors or non-functional kidney can be performed laparoscopic radical cystectomy and nephroureterectomy with lomboaortic and pelvic lymph node dissection. We present our initial experience.

Methods: Between 2018 and 2019, 4 patients underwent laparoscopic radical cystectomy and unilateral nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection. The nephroureterectomy was the first part of the surgery. After it, the radical cystectomy with lymphadenectomy was performed. All the specimes were removed en bloc in an endobag through a midline incision.

Results: Patients demographic characteristics and perioperative outcomes were retrospectively collected and evaluated. All surgeries were completed laproscopically. There was no need of conversion to open surgery. The mean operative time was 286,25 min with minimal blood loss (260 ml). No major complications were reported. The mean follow-up period was 8,75 months.

Conclusion: Laparoscopic radical cystectomy and nephroureterectomy en bloc resection with lomboaortic and pelvic lymph node dissection can be safe and feasible in selected cases as an alternative approach to the open surgery, offering good oncological and functional results.