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Editor’s note iNature is China’s largest academic public account.
It is jointly created by a team of doctors from Tsinghua University, Harvard University, Chinese Academy of Sciences and other units.
The iNature talent public account is now launched, focusing on talent recruitment, academic progress, scientific research information, interested parties can Long press or scan the QR code below to follow us
.
iNature chronic urinary retention (CUR) is a common complication after orthotopic neobladder (ONB) reconstruction in women
.
In order to reduce CUR, based on the pelvic anatomy differences between women and men, several open surgical modifications have been established to provide back support for ONB
.
On November 30, 2021, the Chen Zhiwen team of the Army Military Medical University published an online research paper entitled "Preliminary Functional Outcome Following Robotic Intracorporeal Orthotopic Ileal Neobladder Suspension with Round Ligaments in Women with Bladder Cancer" in European Urology (IF=20).
From November 2017 to April 2021, 28 patients received ONB in the robot (robot radical cystectomy, pelvic lymphadenectomy and complete external round ligament suspension (rONB)) in a single center Followed up for at least 6 months
.
The perioperative and 90-day complications and 6-month functional results were compared between the rONB group (n = 12) and patients receiving traditional ONB (tONB; n = 16)
.
The median total operating time for tONB is 305 minutes (interquartile range [IQR] 270-370), and for rONB is 303 minutes (IQR 287-330)
.
The estimated median blood loss for tONB is 325 ml (IQR 200–700), and the estimated blood loss for rONB is 350 ml (IQR 262–600)
.
Approximately 50% of the tONB group and 41.
7% of the rONB group experienced low-grade complications
.
A total of 12.
5% of tONB and 8.
3% of rONB patients experienced high complications of neovesicovaginal fistula
.
The cumulative risks of CUR in the tONB group and rONB group were 37.
5% and 16.
7%, respectively
.
This study is limited by the small sample size and short follow-up time
.
In conclusion, this research establishes a feasible surgical technique for the configuration of ONB in the robot body that suspends the circular ligament, which can prevent the occurrence of female emptying dysfunction
.
The gold standard treatment for patients with muscular invasive and high-risk recurrent bladder cancer is radical cystectomy (RC) plus urinary diversion
.
In situ neobladder (ONB) is considered the best form of urinary diversion because it most resembles a natural bladder
.
However, ONB is still associated with the risk of urinary complications that significantly affect the patient's quality of life
.
In addition, compared with patients receiving ileal catheters, patients receiving ONB have a higher risk of long-term serious complications and reoperation
.
In this case, women experience different complications from men, usually related to urinary dysfunction.
Chronic urinary retention (CUR) is an important functional complication of ONB, which occurs for a long time in 31-61% of cases
.
Local anatomy and nerves are possible causes of urinary dysfunction
.
Regarding the differences in pelvic anatomy between women and men, some surgeons and researchers attribute CUR to the lack of posterior support of the neobladder, causing it to move downward, causing the neobladder-urethral anastomosis to become kinked backwards
.
Therefore, certain surgical modifications have been introduced to provide back support for the new bladder and significantly reduce the incidence of CUR
.
The main results of the article (picture from European Urology) Researchers have developed an improved open surgery method in which the posterior ileum neobladder is suspended with a round ligament, and a single center trial conducted in 2011 obtained better functional results
.
However, in the era of robotic surgery, it has been proven that ONB reconstruction in vivo is safe and feasible
.
Especially for women, the specimen can be taken through the vagina without having to make an additional incision in the abdominal wall
.
Based on novel open methods and experience, the advantages of RC in the robot and female urinary diversion, researchers are encouraged to explore the reconfiguration of ONB in the robot to use the round ligament of female patients to provide back support for ONB
.
The purpose of this study was to describe the in vivo technical and initial functional results compared to patients without ONB back support
.
In this study, from November 2017 to April 2021, 28 patients received ONB in the robot (underwent robotic radical cystectomy, pelvic lymphadenectomy, and complete external round ligament suspension (rONB)).
A single center has been followed up for at least 6 months
.
The perioperative and 90-day complications and 6-month functional results were compared between the rONB group (n = 12) and patients receiving traditional ONB (tONB; n = 16)
.
The median total operating time for tONB is 305 minutes (interquartile range [IQR] 270-370), and for rONB is 303 minutes (IQR 287-330)
.
The estimated median blood loss for tONB is 325 ml (IQR 200–700), and the estimated blood loss for rONB is 350 ml (IQR 262–600)
.
Approximately 50% of the tONB group and 41.
7% of the rONB group experienced low-grade complications
.
A total of 12.
5% of tONB and 8.
3% of rONB patients experienced high complications of neovesicovaginal fistula
.
The cumulative risks of CUR in the tONB group and rONB group were 37.
5% and 16.
7%, respectively
.
This study is limited by the small sample size and short follow-up time
.
In conclusion, this research establishes a feasible surgical technique for the configuration of ONB in the robot body that suspends the circular ligament, which can prevent the occurrence of female emptying dysfunction
.
Reference message: https://#%20
It is jointly created by a team of doctors from Tsinghua University, Harvard University, Chinese Academy of Sciences and other units.
The iNature talent public account is now launched, focusing on talent recruitment, academic progress, scientific research information, interested parties can Long press or scan the QR code below to follow us
.
iNature chronic urinary retention (CUR) is a common complication after orthotopic neobladder (ONB) reconstruction in women
.
In order to reduce CUR, based on the pelvic anatomy differences between women and men, several open surgical modifications have been established to provide back support for ONB
.
On November 30, 2021, the Chen Zhiwen team of the Army Military Medical University published an online research paper entitled "Preliminary Functional Outcome Following Robotic Intracorporeal Orthotopic Ileal Neobladder Suspension with Round Ligaments in Women with Bladder Cancer" in European Urology (IF=20).
From November 2017 to April 2021, 28 patients received ONB in the robot (robot radical cystectomy, pelvic lymphadenectomy and complete external round ligament suspension (rONB)) in a single center Followed up for at least 6 months
.
The perioperative and 90-day complications and 6-month functional results were compared between the rONB group (n = 12) and patients receiving traditional ONB (tONB; n = 16)
.
The median total operating time for tONB is 305 minutes (interquartile range [IQR] 270-370), and for rONB is 303 minutes (IQR 287-330)
.
The estimated median blood loss for tONB is 325 ml (IQR 200–700), and the estimated blood loss for rONB is 350 ml (IQR 262–600)
.
Approximately 50% of the tONB group and 41.
7% of the rONB group experienced low-grade complications
.
A total of 12.
5% of tONB and 8.
3% of rONB patients experienced high complications of neovesicovaginal fistula
.
The cumulative risks of CUR in the tONB group and rONB group were 37.
5% and 16.
7%, respectively
.
This study is limited by the small sample size and short follow-up time
.
In conclusion, this research establishes a feasible surgical technique for the configuration of ONB in the robot body that suspends the circular ligament, which can prevent the occurrence of female emptying dysfunction
.
The gold standard treatment for patients with muscular invasive and high-risk recurrent bladder cancer is radical cystectomy (RC) plus urinary diversion
.
In situ neobladder (ONB) is considered the best form of urinary diversion because it most resembles a natural bladder
.
However, ONB is still associated with the risk of urinary complications that significantly affect the patient's quality of life
.
In addition, compared with patients receiving ileal catheters, patients receiving ONB have a higher risk of long-term serious complications and reoperation
.
In this case, women experience different complications from men, usually related to urinary dysfunction.
Chronic urinary retention (CUR) is an important functional complication of ONB, which occurs for a long time in 31-61% of cases
.
Local anatomy and nerves are possible causes of urinary dysfunction
.
Regarding the differences in pelvic anatomy between women and men, some surgeons and researchers attribute CUR to the lack of posterior support of the neobladder, causing it to move downward, causing the neobladder-urethral anastomosis to become kinked backwards
.
Therefore, certain surgical modifications have been introduced to provide back support for the new bladder and significantly reduce the incidence of CUR
.
The main results of the article (picture from European Urology) Researchers have developed an improved open surgery method in which the posterior ileum neobladder is suspended with a round ligament, and a single center trial conducted in 2011 obtained better functional results
.
However, in the era of robotic surgery, it has been proven that ONB reconstruction in vivo is safe and feasible
.
Especially for women, the specimen can be taken through the vagina without having to make an additional incision in the abdominal wall
.
Based on novel open methods and experience, the advantages of RC in the robot and female urinary diversion, researchers are encouraged to explore the reconfiguration of ONB in the robot to use the round ligament of female patients to provide back support for ONB
.
The purpose of this study was to describe the in vivo technical and initial functional results compared to patients without ONB back support
.
In this study, from November 2017 to April 2021, 28 patients received ONB in the robot (underwent robotic radical cystectomy, pelvic lymphadenectomy, and complete external round ligament suspension (rONB)).
A single center has been followed up for at least 6 months
.
The perioperative and 90-day complications and 6-month functional results were compared between the rONB group (n = 12) and patients receiving traditional ONB (tONB; n = 16)
.
The median total operating time for tONB is 305 minutes (interquartile range [IQR] 270-370), and for rONB is 303 minutes (IQR 287-330)
.
The estimated median blood loss for tONB is 325 ml (IQR 200–700), and the estimated blood loss for rONB is 350 ml (IQR 262–600)
.
Approximately 50% of the tONB group and 41.
7% of the rONB group experienced low-grade complications
.
A total of 12.
5% of tONB and 8.
3% of rONB patients experienced high complications of neovesicovaginal fistula
.
The cumulative risks of CUR in the tONB group and rONB group were 37.
5% and 16.
7%, respectively
.
This study is limited by the small sample size and short follow-up time
.
In conclusion, this research establishes a feasible surgical technique for the configuration of ONB in the robot body that suspends the circular ligament, which can prevent the occurrence of female emptying dysfunction
.
Reference message: https://#%20
