Cancer Management and Research (Mar 2021)
A Novel Neobladder-Urethral Drag-and-Bond Anastomosis Technique During Laparoscopic Radical Cystectomy for Ileal Orthotopic Neobladder: Surgical Technique and Initial Research
Abstract
Zhaojun Yu,1– 3 Jianbiao Huang,1– 3 Huanhuan Deng,1,3 Zhihua Zeng,1 Leihong Deng,4 Xiangda Xu,1 Haichao Chao,1 Tao Zeng1 1Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of China; 2Department of Urology, The People’s Hospital Affiliated to Nanchang University, Nanchang, 330006, People’s Republic of China; 3Medical Department, Nanchang University, Nanchang, 330006, People’s Republic of China; 4Department of Ultrasound, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, People’s Republic of ChinaCorrespondence: Tao ZengDepartment of Urology, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi Province, 330006, People’s Republic of ChinaTel +8613607919171Email [email protected]: To explore the application of the neobladder-urethral drag-and-bond anastomosis technique in laparoscopic radical cystectomy (LRC) with ileal orthotopic neobladder (IONB) reconstruction.Patients and Methods: This is a retrospective cohort study on a procedure performed by a single surgeon. From January 2014 to December 2018, we identified 43 male bladder cancer patients who received LRC with IONB reconstruction. These patients were divided into two groups, with 22 patients undergoing neobladder-urethral drag-and-bond anastomosis (NUDA) and 21 patients undergoing neobladder-urethral anastomosis under laparoscopy (NUAL). Anastomosis time, catheter removal time, postvoid residual (PVR), maximum urinary flow rate (Q-max), urine leakage and anastomotic stenosis were used to evaluate the simplicity and surgical effect of the two groups.Results: Both groups demonstrated similar tumor characteristics. A significant difference in neobladder-urethral anastomosis time was found between the NUDA group and the NUAL group (14.6 ± 0.4 vs 70 ± 2.5 min, P< 0.0001), and there was no significant difference in other characteristics.Conclusion: The neobladder-urethral drag-and-bond anastomosis technique in LRC and IONB reconstruction, with its shorter learning curve, was easier and more convenient than neobladder-urethral anastomosis under laparoscopy.Keywords: drag-and-bond anastomosis, neobladder-urethral anastomosis, laparoscopic radical cystectomy, ileal orthotopic neobladder, bladder cancer
