Outcomes and Complications of Simultaneous Laparoscopic Cystectomy and Laparoscopic Nephroureterectomy with Umbilical Reduced Port Surgery

Abstract

Objective: In recent years, although reduced port surgeries (RPS) have been reported for many urological diseases,<br />there have been no reports regarding simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy<br />with umbilical RPS. Therefore, the aim of this study was to evaluate outcomes and complications of simultaneous<br />laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS. Methods: We performed<br />a preliminary case series of 4 patients with synchronous upper urinary tract (UUT) tumor and invasive bladder cancer<br />who underwent simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS<br />between 2014 and 2017 at our hospital. Demographic data, pathologic features, the surgical technique, and outcomes<br />were retrospectively analyzed. Result: All 4 patients were men whose median age was 79 years (range 65-85 years) and<br />median body mass index was 24.2 kg/m2 (range 21.5-27.3 kg/m2). The laparoscopic approach was technically successful<br />in all 4 patients without the need for open conversion. The median total operative time was 434 minutes (range 372-481<br />minutes). The median estimated blood loss was 773 ml (range 153-923 ml), median interval to resuming oral intake<br />was 2 days (range 1-7 days), and median hospital stay was 16 days (range 13-20 days). Conclusion: The reduced port<br />approach is technically feasible in terms of many outcome measures, with significant cosmetic advantages. This method<br />can be performed safely and recommended as a viable option for patients with concomitant UUT and bladder cancer.