Cargando…
Cystoscopic-assisted partial cystectomy: description of technique and results
BACKGROUND: Partial cystectomy provides oncological results comparable with those of radical cystectomy in selected patients with invasive bladder cancer without the morbidity associated with radical cystectomy and urinary diversion. We describe a novel technique of partial cystectomy that allows ac...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216031/ https://www.ncbi.nlm.nih.gov/pubmed/25368846 http://dx.doi.org/10.2147/RRU.S66861 |
_version_ | 1782342197584068608 |
---|---|
author | Gofrit, Ofer N Shapiro, Amos Katz, Ran Duvdevani, Mordechai Yutkin, Vladimir Landau, Ezekiel H Zorn, Kevin C Hidas, Guy Pode, Dov |
author_facet | Gofrit, Ofer N Shapiro, Amos Katz, Ran Duvdevani, Mordechai Yutkin, Vladimir Landau, Ezekiel H Zorn, Kevin C Hidas, Guy Pode, Dov |
author_sort | Gofrit, Ofer N |
collection | PubMed |
description | BACKGROUND: Partial cystectomy provides oncological results comparable with those of radical cystectomy in selected patients with invasive bladder cancer without the morbidity associated with radical cystectomy and urinary diversion. We describe a novel technique of partial cystectomy that allows accurate identification of tumor margins while minimizing damage to the rest of the bladder. METHODS: During the study period, 30 patients underwent partial cystectomy for invasive high-grade cancer. In 19 patients, the traditional method of tumor identification was used, ie, identifying the tumor by palpation and cystotomy. In eleven patients, after mobilization of the bladder, flexible cystoscopy was done and the light of the cystoscope was pointed toward one edge of the planned resected ellipse around the tumor, thus avoiding cystotomy. RESULTS: Patients who underwent partial cystectomy using the novel method were similar in all characteristics to patients operated on using the traditional technique except for tumor diameter which was significantly larger in patients operated on using the novel method (4.3±1.5 cm versus 3.11±1.18 cm, P=0.032). Complications were rare in both types of surgery. The 5-year local recurrence-free survival was marginally superior using the novel method (0.8 versus 0.426, P=0.088). Overall, disease-specific and disease-free survival rates were similar. CONCLUSION: The use of a flexible cystoscope during partial cystectomy is a simple, low-cost maneuver that assists in planning the bladder incision and minimizes injury to the remaining bladder by avoiding the midline cystotomy. Initial oncological results show a trend toward a lower rate of local recurrence compared with the standard method. |
format | Online Article Text |
id | pubmed-4216031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-42160312014-11-03 Cystoscopic-assisted partial cystectomy: description of technique and results Gofrit, Ofer N Shapiro, Amos Katz, Ran Duvdevani, Mordechai Yutkin, Vladimir Landau, Ezekiel H Zorn, Kevin C Hidas, Guy Pode, Dov Res Rep Urol Original Research BACKGROUND: Partial cystectomy provides oncological results comparable with those of radical cystectomy in selected patients with invasive bladder cancer without the morbidity associated with radical cystectomy and urinary diversion. We describe a novel technique of partial cystectomy that allows accurate identification of tumor margins while minimizing damage to the rest of the bladder. METHODS: During the study period, 30 patients underwent partial cystectomy for invasive high-grade cancer. In 19 patients, the traditional method of tumor identification was used, ie, identifying the tumor by palpation and cystotomy. In eleven patients, after mobilization of the bladder, flexible cystoscopy was done and the light of the cystoscope was pointed toward one edge of the planned resected ellipse around the tumor, thus avoiding cystotomy. RESULTS: Patients who underwent partial cystectomy using the novel method were similar in all characteristics to patients operated on using the traditional technique except for tumor diameter which was significantly larger in patients operated on using the novel method (4.3±1.5 cm versus 3.11±1.18 cm, P=0.032). Complications were rare in both types of surgery. The 5-year local recurrence-free survival was marginally superior using the novel method (0.8 versus 0.426, P=0.088). Overall, disease-specific and disease-free survival rates were similar. CONCLUSION: The use of a flexible cystoscope during partial cystectomy is a simple, low-cost maneuver that assists in planning the bladder incision and minimizes injury to the remaining bladder by avoiding the midline cystotomy. Initial oncological results show a trend toward a lower rate of local recurrence compared with the standard method. Dove Medical Press 2014-10-24 /pmc/articles/PMC4216031/ /pubmed/25368846 http://dx.doi.org/10.2147/RRU.S66861 Text en © 2014 Gofrit et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Gofrit, Ofer N Shapiro, Amos Katz, Ran Duvdevani, Mordechai Yutkin, Vladimir Landau, Ezekiel H Zorn, Kevin C Hidas, Guy Pode, Dov Cystoscopic-assisted partial cystectomy: description of technique and results |
title | Cystoscopic-assisted partial cystectomy: description of technique and results |
title_full | Cystoscopic-assisted partial cystectomy: description of technique and results |
title_fullStr | Cystoscopic-assisted partial cystectomy: description of technique and results |
title_full_unstemmed | Cystoscopic-assisted partial cystectomy: description of technique and results |
title_short | Cystoscopic-assisted partial cystectomy: description of technique and results |
title_sort | cystoscopic-assisted partial cystectomy: description of technique and results |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216031/ https://www.ncbi.nlm.nih.gov/pubmed/25368846 http://dx.doi.org/10.2147/RRU.S66861 |
work_keys_str_mv | AT gofritofern cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT shapiroamos cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT katzran cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT duvdevanimordechai cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT yutkinvladimir cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT landauezekielh cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT zornkevinc cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT hidasguy cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults AT podedov cystoscopicassistedpartialcystectomydescriptionoftechniqueandresults |