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Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer

Radical cystectomy (RC) is an integral part of the management of patients with advanced-stage bladder cancer. This major oncologic operation is prone to complications resulting in morbidity and mortality. We analyzed the critical steps of open RC, performed an evidence-based review of these steps, a...

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Autores principales: D’Andrea, Vincent D., Melnick, Kevin, Yim, Kendrick, Ernandez, John, Onochie, Nnamdi, Clinton, Timothy N., Steele, Graeme S., Preston, Mark A., Kibel, Adam S., Mossanen, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647807/
https://www.ncbi.nlm.nih.gov/pubmed/37959309
http://dx.doi.org/10.3390/jcm12216845
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author D’Andrea, Vincent D.
Melnick, Kevin
Yim, Kendrick
Ernandez, John
Onochie, Nnamdi
Clinton, Timothy N.
Steele, Graeme S.
Preston, Mark A.
Kibel, Adam S.
Mossanen, Matthew
author_facet D’Andrea, Vincent D.
Melnick, Kevin
Yim, Kendrick
Ernandez, John
Onochie, Nnamdi
Clinton, Timothy N.
Steele, Graeme S.
Preston, Mark A.
Kibel, Adam S.
Mossanen, Matthew
author_sort D’Andrea, Vincent D.
collection PubMed
description Radical cystectomy (RC) is an integral part of the management of patients with advanced-stage bladder cancer. This major oncologic operation is prone to complications resulting in morbidity and mortality. We analyzed the critical steps of open RC, performed an evidence-based review of these steps, and discussed our experience and approach. We conducted a literature review of the open RC technique, identified the critical steps that consistently appeared across different sources, and organized these steps into a framework. PubMed was queried with the critical steps as keywords for relevant articles published from 1 January 2013 to 1 August 2023. We utilized this query to conduct a systematic review of the literature using the outcomes of overall survival and 90-day complication rate. We developed the “Summary for the 10 Critical Operative Steps of Radical Cystectomy”, a concise guide to the approach to open RC. When available, an evidence-based analysis of each critical step was performed. We also included additional components of cystectomy optimization such as pre-habilitation in the preoperative phase, standard versus extended lymphadenectomy, the vaginal-sparing approach to female radical cystectomy, patient-reported outcomes following urinary diversion, the use of a mesh for stoma formation, and the use of the ERAS protocol for postoperative care. An evidence-based assessment of RC may help provide valuable information to optimize surgical techniques and patient outcomes.
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spelling pubmed-106478072023-10-30 Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer D’Andrea, Vincent D. Melnick, Kevin Yim, Kendrick Ernandez, John Onochie, Nnamdi Clinton, Timothy N. Steele, Graeme S. Preston, Mark A. Kibel, Adam S. Mossanen, Matthew J Clin Med Review Radical cystectomy (RC) is an integral part of the management of patients with advanced-stage bladder cancer. This major oncologic operation is prone to complications resulting in morbidity and mortality. We analyzed the critical steps of open RC, performed an evidence-based review of these steps, and discussed our experience and approach. We conducted a literature review of the open RC technique, identified the critical steps that consistently appeared across different sources, and organized these steps into a framework. PubMed was queried with the critical steps as keywords for relevant articles published from 1 January 2013 to 1 August 2023. We utilized this query to conduct a systematic review of the literature using the outcomes of overall survival and 90-day complication rate. We developed the “Summary for the 10 Critical Operative Steps of Radical Cystectomy”, a concise guide to the approach to open RC. When available, an evidence-based analysis of each critical step was performed. We also included additional components of cystectomy optimization such as pre-habilitation in the preoperative phase, standard versus extended lymphadenectomy, the vaginal-sparing approach to female radical cystectomy, patient-reported outcomes following urinary diversion, the use of a mesh for stoma formation, and the use of the ERAS protocol for postoperative care. An evidence-based assessment of RC may help provide valuable information to optimize surgical techniques and patient outcomes. MDPI 2023-10-30 /pmc/articles/PMC10647807/ /pubmed/37959309 http://dx.doi.org/10.3390/jcm12216845 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
D’Andrea, Vincent D.
Melnick, Kevin
Yim, Kendrick
Ernandez, John
Onochie, Nnamdi
Clinton, Timothy N.
Steele, Graeme S.
Preston, Mark A.
Kibel, Adam S.
Mossanen, Matthew
Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title_full Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title_fullStr Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title_full_unstemmed Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title_short Evidence-Based Analysis of the Critical Steps of Radical Cystectomy for Bladder Cancer
title_sort evidence-based analysis of the critical steps of radical cystectomy for bladder cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647807/
https://www.ncbi.nlm.nih.gov/pubmed/37959309
http://dx.doi.org/10.3390/jcm12216845
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