Laparoscopic partial cystectomy for urachal and bladder cancer

Authors

  • Jose R. Colombo Jr. Glickman Urological Institute; Cleveland Clinic
  • Mihir Desai Glickman Urological Institute; Cleveland Clinic
  • David Canes Glickman Urological Institute; Cleveland Clinic
  • Rodrigo Frota Glickman Urological Institute; Cleveland Clinic
  • Georges-Pascal Haber Glickman Urological Institute; Cleveland Clinic
  • Alireza Moinzadeh Glickman Urological Institute; Cleveland Clinic
  • Ingolf Tuerk Lahey Clinic; Department of Urology
  • Mahesh R. Desai Urological Hospital; Department of Urology
  • Inderbir S. Gill Glickman Urological Institute; Cleveland Clinic

DOI:

https://doi.org/10.1590/S1807-59322008000600004

Keywords:

Partial cystectomy, Laparoscopy, Bladder cancer, Urachal carcinoma, Outcomes

Abstract

PURPOSE: To report our initial experiences with laparoscopic partial cystectomy for urachal and bladder malignancy. MATERIALS AND METHODS: Between March 2002 and October 2004, laparoscopic partial cystectomy was performed in 6 cases at 3 institutions; 3 cases were urachal adenocarcinomas and the remaining 3 cases were bladder transitional cell carcinomas. All patients were male, with a median age of 55 years (45-72 years). Gross hematuria was the presenting symptom in all patients, and diagnosis was established with trans-urethral resection bladder tumor in 2 patients and by means of cystoscopic biopsy in the remaining 4 patients. Laparoscopic partial cystectomy was performed using the transperitoneal approach under cystoscopic guidance. In each case, the surgical specimen was removed intact entrapped in an impermeable bag. One patient with para-ureteral diverticulum transitional cell carcinoma required concomitant ureteral reimplantation. RESULTS: All six procedures were completed laparoscopically without open conversion. The median operating time was 110 minutes (90-220) with a median estimated blood loss of 70 mL (50-100). Frozen section evaluations of bladder margins were routinely obtained and were negative for cancer in all cases. The median hospital stay was 2.5 days (2-4) and the duration of catheterization was 7 days. There were no intraoperative or postoperative complications. Final histopathology confirmed urachal adenocarcinoma in 3 cases and bladder transitional cell carcinoma in 3 cases. At a median follow-up of 28.5 months (range: 26 to 44 months), there was no evidence of recurrent disease as evidenced by radiologic or cystoscopic evaluation. CONCLUSIONS: Laparoscopic partial cystectomy in carefully selected patients with urachal and bladder cancer is feasible and safe, offering a promising and minimally invasive alternative for these patients.

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Published

2008-01-01

Issue

Section

Clinical Sciences

How to Cite

Colombo Jr., J. R., Desai, M., Canes, D., Frota, R., Haber, G.-P., Moinzadeh, A., Tuerk, I., Desai, M. R., & Gill, I. S. (2008). Laparoscopic partial cystectomy for urachal and bladder cancer . Clinics, 63(6), 731-734. https://doi.org/10.1590/S1807-59322008000600004