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Japanese Journal of Clinical Oncology 2008 38(9):611-616; doi:10.1093/jjco/hyn079
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© The Author (2008). Published by Oxford University Press. All rights reserved

Minilaparotomy Radical Cystoprostatectomy (Minilap RCP) in the Surgical Management of Urinary Bladder Carcinoma: Early Experience

Sudhir Rawal, S.K. Raghunath, Samir Khanna, Deepak Jain, Rakesh Kaul, Prem Kumar, Rakesh Chhabra and Kirti Bhushan

Department of Uro-oncology, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India

For reprints and all correspondence: Sudhir Rawal, Department of Uro-oncology, Rajiv Gandhi Cancer Institute and Research Center, Sector 5, Rohini, New Delhi 110085, India. E-mail: dr_rawal{at}yahoo.com

Received February 6, 2008; accepted July 22, 2008

Objective: To assess the feasibility of minilaparotomy for radical cystoprostatectomy (RCP) and urinary diversion in the management of urinary bladder carcinoma.

Methods: A total of 45 consecutive patients with muscle invasive urinary bladder cancer underwent RCP and urinary diversion [32, 12 and 1 patients with pitchers pot orthotopic neobladder (NB), ileal conduit (IC) and sigma rectal pouch respectively], between May 2006 and June 2007, using 8–12 cm infraumbilical midline vertical incision from pubic symphysis, were prospectively analyzed for technical feasibility, operative time, blood loss, intraoperative and postoperative complications and return of bowel function.

Results: All the patients were males with average age of 59.65 years (44–79 years) and average body mass index of 23.97(17.7–29.5). The length of the incision was 8, 10 and 12 cm in 4, 39 and 2 patients, respectively. The average number of lymph nodes removed on the right and left side was 14 and 16, respectively. The average blood loss was 1046 ml (595–2100 ml). Return of bowel sounds was observed on an average by second postoperative day (1–5 days). Average postoperative stay was 14 days (range 10–24 days) for NB and 7 days (6–8 days) for IC patients. One (2.22%) patient died on the 18th postoperative day due to septicemia and acute renal failure.

Conclusion: Minilaparotomy RCP is technically feasible without compromising the oncological principles. Complete removal of urachus and adequate clearance of pelvic lymph nodes is not difficult with the small incision. Early restoration of bowel function, early postoperative recovery and good cosmesis seem to be the main advantages.

Key Words: minilaparotomy radical cystoprostatectomy • radical cystoprostatectomy • orthotopic neobladder • ileal conduit • sigma rectum pouch


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