Topic
Cystoprostatectomy
About: Cystoprostatectomy is a research topic. Over the lifetime, 554 publications have been published within this topic receiving 13966 citations.
Papers published on a yearly basis
Papers
TL;DR: In this article, a technique of nerve-sparing robot-assisted radical cystoprostatectomy (RRCP) for patients with bladder cancer was developed using a six-port approach and the da Vinci Surgical system.
Abstract: OBJECTIVE
To develop a technique of nerve-sparing robot-assisted radical cystoprostatectomy (RRCP) for patients with bladder cancer.
PATIENTS AND METHODS
Robotic assistance should enhance the ability to preserve the neurovascular bundles during laparoscopic radical cystectomy. Thus we undertook RRCP and urinary diversion using a three-step technique. First, using a six-port approach and the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), one surgeon carried out a complete pelvic lymphadenectomy and cystoprostatectomy using a technique developed specifically for robotic surgery. The neurovascular bundles were easily identified and dissected away, the specimen entrapped in a bag and removed through a 5–6 cm suprapubic incision. Second, a different surgical team exteriorized the bowel through this incision and created a neobladder extracorporeally. Third, the neobladder was internalized, the incision closed and the primary surgeon completed the urethro-neovesical anastomosis with robotic assistance.
RESULTS
RRCP was carried out in 14 men and three women by the primary surgeon (M.M.). The form of urinary reconstruction was ileal conduit in three, a W-pouch with a serosal-lined tunnel in 10, a double-chimney or a T-pouch with a serosal-lined tunnel in two each. The mean operative duration for robotic radical cystectomy, ileal conduit and orthotopic neobladder were 140, 120 and 168 min, respectively. The mean blood loss was < 150 mL. The number of lymph nodes removed was 4–27, with one patient having N1 disease. The margins of resection were free of tumour in all patients.
CONCLUSIONS
We developed a technique for nerve-sparing RRCP using the da Vinci system which allows precise and rapid removal of the bladder with minimal blood loss. The bowel segment can be exteriorized and the most complex form of orthotopic bladder can be created through the incision used to deliver the cystectomy specimen. Performing this part of the operation extracorporeally reduced the operative duration.
595 citations
TL;DR: This trial failed to identify a large advantage for robot-assisted techniques over standard open surgery for patients undergoing radical cystectomy, pelvic lymph node dissection, and urinary diversion and found no significant difference between the two groups.
563 citations
TL;DR: It was concluded that additional incidental tumors are common in patients with prostate cancer, but their sum of volumes is seldom as large as the clinical cancer volume.
Abstract: Multiple independent tumors were identified in specimens from 117 of 234 prostatectomies for clinical adenocarcinoma; there were 266 incidental cancers in these 117 prostates. The clinically detected carcinoma was the largest (or only) tumor in all 202 Stage B cases. However, among 32 Stage A cases (detection by transurethral resection), there were 8 prostates in which an incidental tumor was larger than the clinically manifest cancer. These were all small tumors except for two incidental cancers with a volume greater than 2cm3; roughly 80% of incidental carcinomas were smaller than 0.5 cm3, whereas fewer than 20% of manifest tumors were smaller than 0.5 cm3. Comparison with a series of cancers found incidentally at cystoprostatectomy for bladder cancer showed the same volume distribution as incidental (smaller) carcinomas in patients with prostate cancer. This distribution was thought to reflect the volume distribution of prostate cancer in the general population older than 50 years of age. It was concluded that additional incidental tumors are common in patients with prostate cancer, but their sum of volumes is seldom as large as the clinical cancer volume.
258 citations
TL;DR: The prostate glands of 84 men undergoing cystoprostatectomy for bladder cancer were examined by whole‐mount sections at 4‐mm to 5‐mm intervals to identify unsuspected prostate adenocarcinoma (PCa), and of 72 white patients with entirely normal digital rectal examinations (DRE), 33 were found to have PCa.
Abstract: The prostate glands of 84 men undergoing cystoprostatectomy for bladder cancer were examined by whole-mount sections at 4-mm to 5-mm intervals to identify unsuspected prostate adenocarcinoma (PCa). Of 72 white patients with entirely normal digital rectal examinations (DRE), 33 (46%) were found to have PCa, including 12 (17%) who had a Gleason score of 6 or greater and seven (10%) who had penetration through the prostatic capsule. These observations are consistent with previous studies in autopsy populations but allow a more appropriate comparison with morphologic data generated from radical prostatectomy specimens. If these data can be extended to the age-matched general population, treatment at a 1% mortality rate for all white men 60 to 74 years of age with a PCa with a Gleason score of 6 or greater could cause between 6190 and 30,951 deaths, in contrast to 7335 deaths expected from the cancer. These data stress the need for a control group in a study designed to evaluate the benefit of early diagnosis and treatment of PCa.
208 citations
TL;DR: The Carney enterocystoplasty is a technique for constructing a functional, continent bladder in male patients following cystoprostatectomy for carcinoma and 84 patients treated during a 25-year interval are reviewed.
187 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2025 | 7 |
| 2024 | 11 |
| 2023 | 11 |
| 2022 | 28 |
| 2021 | 15 |
| 2020 | 15 |