Two-Port Approach Compared to Standard Laparoscopic Radical Cystectomy

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dc.contributor.author Angulo Cuesta, Javier
dc.contributor.author García Tello, Ana
dc.contributor.author Mateo Martínez, Erika
dc.contributor.author Gimbernat, H.
dc.contributor.author Redondo, Cristina
dc.contributor.author Guillermo, Andrés
dc.date.accessioned 2018-06-06T10:57:31Z
dc.date.available 2018-06-06T10:57:31Z
dc.date.issued 2015
dc.identifier.citation Angulo, J. C., García-Tello, A., Mateo, E., Gimbernat, H., Redondo, C., & Andrés, G. (2015). Two-port approach compared to standard laparoscopic radical cystectomy. Journal of Endourology, 29(9), 1030-1037. DOI:10.1089/end.2015.0161 spa
dc.identifier.issn 0892-7790
dc.identifier.issn 1557-900X
dc.identifier.uri http://hdl.handle.net/11268/7285
dc.description.abstract Background and Objectives: Two-port laparoscopic radical cystectomy (LRC) using a multichannel platform through the umbilicus and one additional 10-mm in the right iliac fossa has been recently described. We compare the perioperative and early results of this technique with a cohort of patients simultaneously treated in our institution with four-port LRC and a 7 to 10 cm midline incision.Materials and Methods: A matched-pair study comparing perioperative outcomes, postoperative visual analog pain scale (VAPS), and morbidity of two-port (n=30) and four-port (n=30) LRC. Preoperative and perioperative data analyzed and compared included demographics, type of urinary diversion, operative time, blood loss, transfusion requirements, decrease in serum hemoglobin, operative complications, analgesic needs, length of stay, number of nodes removed, and other pathologic information. Complications in the first 3 months were evaluated according to the Clavien–Dindo classification.Results: There was no significant difference between the two groups regarding patient age, gender, body–mass index, American Society of Anesthesiologists (ASA) score, Charlson comorbidity index, tumor stage, percent of positive nodes, positive margin rate, number of nodes retrieved, proportion of neobladders, secondary carcinoma in situ, incidental prostate cancer, or need of systemic chemotherapy. Median operative time was 20 minutes higher in the two-port procedure, but this difference was not statistically significant (p=0.2). Estimated blood loss and differential hemoglobin change were lower in the two-port technique (each p=0.03), but no difference was detected regarding the intraoperative or postoperative transfusion rate. Length of hospital stay was also equivalent. Differences were not observed either in the number or severity of complications. VAPS at days 2, 3, and 5 was significantly lower for two-port LRC (p<0.01).Conclusions: Two-port LRC performed through an umbilical platform and an accessory 10-mm port seems technically equivalent to standard four-port LRC. Perioperative outcomes regarding hospital stay and complications are tantamount. Diminished blood loss and, especially, less postoperative pain favor the reduced-port approach in this complex urologic minimally invasive procedure. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.subject.other Cistectomía radical laparoscópica spa
dc.title Two-Port Approach Compared to Standard Laparoscopic Radical Cystectomy spa
dc.type article spa
dc.description.impact 2.107 JCR (2015) Q2, 31/77 Urology & Nephrology spa
dc.identifier.doi 10.1089/end.2015.0161
dc.rights.accessRights closedAccess spa
dc.subject.uem Urología spa
dc.subject.unesco Cirugía spa
dc.subject.unesco Tecnología médica spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa

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