Objective: To introduce the initial experience of 11 cases of
modified laparoscopic radical cystectomy and construction of
orthotopic Studer ileal neobladder, and the oncological and
functional results of this procedure.
Methods: From July 2008 through July 2011, 11 selected
patients underwent modified radical cystectomy (1 cm apical
capsule preserved and Wallace technique for ureter-neobladder anastomosis) and standard lymphadenectomy followed by
construction of orthotopic Studer ileal neobladder by minilaparostomy
for muscle invasive bladder cancer. Data were
analyzed according to procedure time, blood loss, transfusion,
number of dissected lymph nodes, peri-operative complications,
morphology and function of upper urinary tract, and status of
Results: Mean operating time was 6.17 (5.5-7.5) hrs, estimated
blood loss 300 (0-800) mL, only one case need transfusion
400 mL, lymph nodes dissected 15 (5-30), no peri-operative
death, peri-operative complications was found in 18% (2/11).
Temporary dilation of upper urinary tract was observed in
18% (2/11) in 45 days post-operative, then disappeared
spontaneously, Serum creatinine remained in normal range
in all patients. With 15 (1-67) months follow-up, 1 case died
of metastasis of squamous cell carcinoma. 91% (10/11)
survived without local relapse or distal metastasis. Complete
daytime continence rate was 90% (9/10); complete night-time
continence rate 70% (7/10) and 1 pad in 20% (2/10).
Conclusions: With intermediate follow-up, the oncological and
functional results are encouraging after modified laparoscopic
radical cystectomy and construction of orthotopic Studer
ileal neobladder by mini-laparostomy in selected cases; The
afferent tubular segment of neobladder is effective to protect the
morphology and function of upper urinary tract.