Trainees Do Not Negatively Impact the Institutional Learning Curve for Robotic Prostatectomy as Characterized by Operative Time, Estimated Blood Loss, and Positive Surgical Margin Rate

详细信息    查看全文

• 作者：Florian R. Schroeck ; Chiquita A. Palha de Sousa ; Ross A. Kalman ; Maitri S. Kalia ; Sean A. Pierre ; George E. Haleblian ; Leon Sun ; Judd W. Moul ; David M. Albala
• 关键词：Bycatch ; Albatross ; Petrel ; Fishery description ; Loggerhead turtle ; Leatherback turtle
• 刊名：Urology
• 出版年：2008
• 出版时间：April 2008
• 年：2008
• 卷：71
• 期：4
• 页码：597-601
• 全文大小：191 K

文摘

From April 1986 to December 2003 radical cystectomy and orthotopic ileal neobladder reconstruction were performed in 760 consecutive patients with bladder cancer, of whom 4 had bladder cancer a median of 10.5 years after renal transplantation. The postoperative clinical course and long-term results in these patients were reviewed.

Results:

Median followup after surgery was 51.5 months (range 11 to 118). Two patients died at 11 and 15 months of tumor progression and a pulmonary embolism, respectively, whereas 2 were alive at a mean followup of 90 months with no evidence of disease. No neobladder related reoperations were necessary. Serum creatinine as a marker of renal function was stable in 3 patients. In 1 patient chronic graft rejection led to progressive renal failure and hemodialysis. Urinary continence was satisfactory during the day and night with spontaneous voiding in all patients and no significant post-void residual urine.

Conclusions:

To our knowledge this is the largest reported series of orthotopic ileal neobladder replacement following radical cystectomy in renal transplant recipients. Our results demonstrate the feasibility of radical cystectomy and orthotopic urinary reconstruction in patients with a renal transplant who have good functional and oncological results despite the high comorbidity in this group.