OBJECTIVE: To study the functional outcomes of 30 patients who had previously undergone laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder reconstruction using videourodynamic (VUDM) assessment 180 days postoperatively. METHODS: Between November 2010 and December 2013, 30 male patients had undergone laparoscopic radical cystectomy with bilateral standard pelvic lymphadenectomy and pure laparoscopic orthotopic ileal U-shaped neobladder diversion. The demographic data were as follows: median age, 67 years (range, 62-79); body mass index, 22.3 kg/m(2) (range, 16-26.1 kg/m(2)); and mean American Society of Anesthesiologists score 2.2 (range, 1-3). Functional outcomes were assessed performing a standard VUDM study combined with perineal floor electromyography 180 days postoperatively. RESULTS: VUDM evaluations showed good functional outcomes of the reservoirs. Mean maximal neobladder capacity was 287 mL (range, 210-335 mL). Residual peristaltic activity was observed in all the individuals evaluated; however, only 9 of 30 individuals (30%) displayed severe peristaltic activity. Six of these 9 individuals (66.6%) experienced urinary leakage during these contractions. Mean postvoid residual volume was 44 mL (range, 0-105 mL), and peak flow rate was 13.9 mL/s (range, 9.7-29.2 mL/s). The Valsalva maneuver was positive in 5 of 30 subjects (17%). Bladder morphology assessed during contrast cystography showed the desired U-shape in all cases. Ureteral reflux was observed in 7 of 30 individuals (23.3%). CONCLUSION: Based on VUDM, our study shows that U-shaped ileal neobladders achieved by a totally laparoscopic approach obtained good functional outcomes. These findings support the evidence that a minimally invasive approach does not impose technical limitations that negatively impact the surgical results.

Videourodynamic evaluation of intracorporeally reconstructed orthotopic U-shaped ileal neobladders / Palleschi, Giovanni; Pastore, ANTONIO LUIGI; Ripoli, Andrea; Silvestri, Luigi; Petrozza, Vincenzo; Carbone, Antonio. - In: UROLOGY. - ISSN 0090-4295. - STAMPA. - 85:4(2015), pp. 883-889. [10.1016/j.urology.2014.09.067]

Videourodynamic evaluation of intracorporeally reconstructed orthotopic U-shaped ileal neobladders

PALLESCHI, GIOVANNI;PASTORE, ANTONIO LUIGI;RIPOLI, ANDREA;SILVESTRI, LUIGI;PETROZZA, Vincenzo;CARBONE, Antonio
2015

Abstract

OBJECTIVE: To study the functional outcomes of 30 patients who had previously undergone laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder reconstruction using videourodynamic (VUDM) assessment 180 days postoperatively. METHODS: Between November 2010 and December 2013, 30 male patients had undergone laparoscopic radical cystectomy with bilateral standard pelvic lymphadenectomy and pure laparoscopic orthotopic ileal U-shaped neobladder diversion. The demographic data were as follows: median age, 67 years (range, 62-79); body mass index, 22.3 kg/m(2) (range, 16-26.1 kg/m(2)); and mean American Society of Anesthesiologists score 2.2 (range, 1-3). Functional outcomes were assessed performing a standard VUDM study combined with perineal floor electromyography 180 days postoperatively. RESULTS: VUDM evaluations showed good functional outcomes of the reservoirs. Mean maximal neobladder capacity was 287 mL (range, 210-335 mL). Residual peristaltic activity was observed in all the individuals evaluated; however, only 9 of 30 individuals (30%) displayed severe peristaltic activity. Six of these 9 individuals (66.6%) experienced urinary leakage during these contractions. Mean postvoid residual volume was 44 mL (range, 0-105 mL), and peak flow rate was 13.9 mL/s (range, 9.7-29.2 mL/s). The Valsalva maneuver was positive in 5 of 30 subjects (17%). Bladder morphology assessed during contrast cystography showed the desired U-shape in all cases. Ureteral reflux was observed in 7 of 30 individuals (23.3%). CONCLUSION: Based on VUDM, our study shows that U-shaped ileal neobladders achieved by a totally laparoscopic approach obtained good functional outcomes. These findings support the evidence that a minimally invasive approach does not impose technical limitations that negatively impact the surgical results.
2015
assisted radical cystectomy; invasive bladder-cancer; complications; laparoscopy; outcomes
01 Pubblicazione su rivista::01a Articolo in rivista
Videourodynamic evaluation of intracorporeally reconstructed orthotopic U-shaped ileal neobladders / Palleschi, Giovanni; Pastore, ANTONIO LUIGI; Ripoli, Andrea; Silvestri, Luigi; Petrozza, Vincenzo; Carbone, Antonio. - In: UROLOGY. - ISSN 0090-4295. - STAMPA. - 85:4(2015), pp. 883-889. [10.1016/j.urology.2014.09.067]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/780395
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