Open RC in patients with MIBC - our clinical experience and review of literature...

Abstract

Author(s): Xhevdet Çuni, Isa Haxhiu, Sabit Mehmeti, Anton Ndoj, Dardan Hoxha, Leutrim Çuni, Donat Cuni, Tevide Shabani, Labinot Shahini

Background: Radical Cystectomy (RC) regardless of the method of implementation (Robotic-Assisted Radical Cystectomy-RARC, Laparoscopy RC or Open RC) still remains a complex operative treatment associated with a number of possible complications. In this study, we retrospectively analyzed 26 patients operated with Open RC with different types of urinary diversion within a period of 18 months in our University Clinical Centre in Pristina. The analysis is focused on some characteristics of the surgical procedures and on the importance of applying the Enhanced Recovery Program (ERP) in the prevention of possible complications. Materials and methods: In this study, we retrospectively analyzed 26 patients with Muscle-Invasive Urinary Bladder Cancer (MIBC)operated with Open RC with different types of urinary diversion within a period of 18 months (01 January 2022 to 30 June 2023) in our University Clinical Centre in Pristina. The analysis is focused on some characteristics of the surgical procedures and on the importance of applying the Enhanced Recovery Program (ERP) in the prevention of possible complications. Results: The Open RC with infraumbilical laparotomy under general and in spinal anesthesia was performed successfully in 26 patients. The most frequent urine diversion was Open CR with uretero cutaneostomy diversion according to Bricker in 10 cases (38%); Open CR with Ureterocutaneostomy Diversion (UCN) in 8 cases (31%); Open CR with ileal bladder substitute diversion (by Hautmann and by Studer) in 8 cases (31%). Pelvic Lymph Node Dissection (PLND) was performed in selective cases. Conclusion: The choice of the type of Open CR with different urinary diversion was made including the age of the patient, the grading with stage of the disease and the accompanying diseases. The application of the Enhanced Recovery Program (ERP) has had a great impact on the success of this surgical treatment.

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