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Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent?
CONTEXT: Radical cystectomy (RC) has complicated surgical procedures and various ways of urinary reconstruction. AIMS: The aim of this study is to investigate whether the advantages of laparoscopy over open surgery were consistent in the perioperative recovery of different methods of urinary diversi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597872/ https://www.ncbi.nlm.nih.gov/pubmed/31929226 http://dx.doi.org/10.4103/jmas.JMAS_227_19 |
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author | Liu, Zhenhua Meng, Yisen Li, Shaobo Yu, Wei Jin, Jie |
author_facet | Liu, Zhenhua Meng, Yisen Li, Shaobo Yu, Wei Jin, Jie |
author_sort | Liu, Zhenhua |
collection | PubMed |
description | CONTEXT: Radical cystectomy (RC) has complicated surgical procedures and various ways of urinary reconstruction. AIMS: The aim of this study is to investigate whether the advantages of laparoscopy over open surgery were consistent in the perioperative recovery of different methods of urinary diversion after RC in the general and the elderly (>65 years) population. SETTINGS AND DESIGN: A retrospective study reviewed 452 (elderly 261) patients who received RC from the year 2005–2012. SUBJECTS AND METHODS: Of all, 88 patients underwent laparoscopic RC (LRC) and 364 patients underwent open RC (ORC). There were 325 patients received ileal conduit (IC), whereas 127 patients received cutaneous ureterostomy (CU). STATISTICAL ANALYSIS USED: We used different statistical methods (t-test, Chi-square, etc.) to compare variables outcomes. RESULTS: For IC urinary diversion, the general patients undergoing LRC had less intra-operative blood loss (566.5 vs. 1320.3 ml, P < 0.001), lower blood transfusion rate (11.4 vs. 34.1%, P < 0.001), shorter gastrointestinal recovery time (5.7 vs. 6.7 days, P = 0.002) and shorter length of hospital stay (LOS) (21.7 vs. 26.0 days, P = 0.003) than patients receiving ORC. Similar trends were observed in older patients. For CU urinary diversion, the general and the elderly patients receiving LRC had a shorter mean time to gastrointestinal recovery (P = 0.017, P < 0.001, respectively) than patients receiving ORC. No differences were found between LRC and ORC in intra-operative blood loss, allogeneic blood transfusion rate and LOS. CONCLUSIONS: In the general and the elderly population, laparoscopic approach could result in more rapid rehabilitation for RC patients, especially in the IC patients. |
format | Online Article Text |
id | pubmed-7597872 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-75978722020-11-03 Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? Liu, Zhenhua Meng, Yisen Li, Shaobo Yu, Wei Jin, Jie J Minim Access Surg Original Article CONTEXT: Radical cystectomy (RC) has complicated surgical procedures and various ways of urinary reconstruction. AIMS: The aim of this study is to investigate whether the advantages of laparoscopy over open surgery were consistent in the perioperative recovery of different methods of urinary diversion after RC in the general and the elderly (>65 years) population. SETTINGS AND DESIGN: A retrospective study reviewed 452 (elderly 261) patients who received RC from the year 2005–2012. SUBJECTS AND METHODS: Of all, 88 patients underwent laparoscopic RC (LRC) and 364 patients underwent open RC (ORC). There were 325 patients received ileal conduit (IC), whereas 127 patients received cutaneous ureterostomy (CU). STATISTICAL ANALYSIS USED: We used different statistical methods (t-test, Chi-square, etc.) to compare variables outcomes. RESULTS: For IC urinary diversion, the general patients undergoing LRC had less intra-operative blood loss (566.5 vs. 1320.3 ml, P < 0.001), lower blood transfusion rate (11.4 vs. 34.1%, P < 0.001), shorter gastrointestinal recovery time (5.7 vs. 6.7 days, P = 0.002) and shorter length of hospital stay (LOS) (21.7 vs. 26.0 days, P = 0.003) than patients receiving ORC. Similar trends were observed in older patients. For CU urinary diversion, the general and the elderly patients receiving LRC had a shorter mean time to gastrointestinal recovery (P = 0.017, P < 0.001, respectively) than patients receiving ORC. No differences were found between LRC and ORC in intra-operative blood loss, allogeneic blood transfusion rate and LOS. CONCLUSIONS: In the general and the elderly population, laparoscopic approach could result in more rapid rehabilitation for RC patients, especially in the IC patients. Wolters Kluwer - Medknow 2020 2020-01-09 /pmc/articles/PMC7597872/ /pubmed/31929226 http://dx.doi.org/10.4103/jmas.JMAS_227_19 Text en Copyright: © 2020 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Liu, Zhenhua Meng, Yisen Li, Shaobo Yu, Wei Jin, Jie Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title | Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title_full | Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title_fullStr | Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title_full_unstemmed | Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title_short | Perioperative recovery in different urinary reconstruction approaches of radical cystectomy: Are the advantages of laparoscopy consistent? |
title_sort | perioperative recovery in different urinary reconstruction approaches of radical cystectomy: are the advantages of laparoscopy consistent? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597872/ https://www.ncbi.nlm.nih.gov/pubmed/31929226 http://dx.doi.org/10.4103/jmas.JMAS_227_19 |
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