Application of the stoma incision-assisted technique in laparoscopic radical cystectomy and ileal conduit

Abstract:

Objective To investigate the safety and practicability of the stoma incision-assisted technique （sampling specimens and performing intestinal anastomosis and ureteral anastomosis through the stoma incision） in laparoscopic radical cystectomy and ileal conduit.Methods In this study，60 patients who had an indication for radical cystectomy or ileal conduit were randomly divided into stoma incision-assisted technique group（experimental group） and traditional lower midline abdominal incision-assisted technique group（control group）. The two groups were compared for urinary diversion operation time，intraoperative blood loss，complication rate，length of postoperative hospital stay，and postoperative pain score.Results The urinary diversion operation time was significantly shorter in the experimental group than in the control group［（105.0±18.9） min vs. （117.0±17.7） min，P<0.05］. The postoperative pain score was significantly lower in the experimental group than in the control group （4.03±1.50 vs. 5.40±1.69，P<0.05）. The length of postoperative hospital stay was significantly shorter in the experimental group than in the control group［（8.27±1.86） days vs. （9.70±1.87） days，P<0.05］. There was no significant difference between the two groups in intraoperative blood loss［experimental group：（260±155） mL，control group：（271±154） mL，P=0.784］. Four cases in the experimental group experienced complications （intestinal obstruction in 2 cases，parastomal hernia in 1 case，and urinary tract infection in 1 case）. Six cases in the control group experienced complications （intestinal obstruction in 3 cases，incision infection in 2 cases，and urinary tract infection in 1 case）. There was no significant difference between the groups in overall complication rate.Conclusion It is safe and feasible to apply the stoma incision-assisted technique in laparoscopic radical cystectomy and ileal conduit，offering a promising application prospect for fast recovery after surgery.