Anatomy and surgical techniques for improving urinary continence of orthotopic ileal neobladder
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摘要: 根治性膀胱切除术是肌层浸润性膀胱癌和高危非肌层浸润性膀胱癌的主要手术方式，原位新膀胱术因生活质量高而成为根治性膀胱切除术后较为理想的尿流改道手术方式。尿失禁是原位新膀胱术后常见的并发症，严重影响患者生活质量。本文对根治性膀胱切除和原位新膀胱术后尿控的相关解剖及创新术式进行系统性回顾，为临床实践工作提供指导。Abstract: Radical cystectomy is the main surgical method for muscle invasive and high risk non-muscle invasive bladder cancer. Orthotopic neobladder has become an ideal surgical method for urinary diversion after radical cystectomy due to its high quality of life. Urinary incontinence is a common complication after orthotopic neobladder surgery, which seriously affects the quality of life of patients. This article systematically reviewed the anatomy and innovative surgical methods of radical cystectomy and orthotopic neobladder reconstruction to provide guidance for clinical practice.
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Key words:
- bladder cancer /
- orthotopic neobladder surgery /
- radical cystectomy /
- urinary continence
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[1] Clifford TG, Shah SH, Bazargani ST, et al. Prospective evaluation of continence following radical cystectomy and orthotopic urinary diversion using a validated questionnaire[J]. J Urol, 2016, 196(6): 1685-1691. doi: 10.1016/j.juro.2016.05.093
[2] Koraitim MM. The male urethral sphincter complex revisited: an anatomical concept and its physiological correlate[J]. J Urol, 2008;179(5): 1683-1689. doi: 10.1016/j.juro.2008.01.010
[3] Heesakkers J, Farag F, Bauer RM, et al. Pathophysiology and contributing factors in postprostatectomy incontinence: a review[J]. Eur Urol, 2017, 71(6): 936-944. doi: 10.1016/j.eururo.2016.09.031
[4] Wang XD, Liu S, Xiong LX, et al. Normal anatomy of urethral sphincter complex in young Chinese males on MRI[J]. Int Urol Nephrol, 2014, 46(8): 1469-1476. doi: 10.1007/s11255-014-0686-1
[5] Good DW, Wood A, Stewart L, et al. Striated muscle in radical prostatectomy specimens: a marker of apical dissection quality and an independent predictor of urinary continence after endoscopic extraperitoneal radical prostatectomy[J]. Urol Int, 2017, 98(1): 71-78. doi: 10.1159/000452632
[6] Sacco E, Prayer-Galetti T, Pinto F, et al. Urinary incontinence after radical prostatectomy: incidence by definition, risk factors and temporal trend in a large series with a long-term follow-up[J]. BJU Int, 2006, 97(6): 1234-1241. doi: 10.1111/j.1464-410X.2006.06185.x
[7] Kim M, Park M, Pak S, et al. Integrity of the urethral sphincter complex, nerve-sparing, and long-term continence status after robotic-assisted radical prostatectomy[J]. Eur Urol Focus, 2019, 5(5): 823-830. doi: 10.1016/j.euf.2018.04.021
[8] Steiner MS. The puboprostatic ligament and the male urethral suspensory mechanism: an anatomic study[J]. Urology, 1994, 44(4): 530-534. doi: 10.1016/S0090-4295(94)80052-9
[9] Zhang C, Ding ZH, Li GX, et al. Perirectal fascia and spaces: annular distribution pattern around the mesorectum[J]. Dis Colon Rectum, 2010, 53(9): 1315-1322. doi: 10.1007/DCR.0b013e3181e74525
[10] Burnett AL, Mostwin JL. In situ anatomical study of the male urethral sphincteric complex: relevance to continence preservation following major pelvic surgery[J]. J Urol, 1998, 160(4): 1301-1306. doi: 10.1016/S0022-5347(01)62521-7
[11] Walsh PC. Anatomical studies of the neurovascular bundle and cavernosal nerves[J]. J Urol, 2005, 174(2): 566. doi: 10.1097/01.ju.0000168033.81966.aa
[12] Costello AJ, Brooks M, Cole OJ. Anatomical studies of the neurovascular bundle and cavernosal nerves[J]. BJU Int, 2004, 94(7): 1071-1076. doi: 10.1111/j.1464-410X.2004.05106.x
[13] Moschovas MC, Patel V. Neurovascular bundle preservation in robotic-assisted radical prostatectomy: How I do it after 15.000 cases[J]. Int Braz J Urol, 2022, 48(2): 212-219. doi: 10.1590/s1677-5538.ibju.2022.99.04
[14] Kowalczyk KJ, Huang AC, Hevelone ND, et al. Stepwise approach for nerve sparing without countertraction during robot-assisted radical prostatectomy: technique and outcomes[J]. Eur Urol, 2011, 60(3): 536-547. doi: 10.1016/j.eururo.2011.05.001
[15] Reeves F, Everaerts W, Murphy DG, et al. Stimulation of the neurovascular bundle results in rhabdosphincter contraction in a proportion of men undergoing radical prostatectomy[J]. Urology 2016, 87: 133-139. doi: 10.1016/j.urology.2015.09.016
[16] Xiong X, Qiu S, Yi X, et al. Effect of neurovascular bundle sparing radical cystectomy on post-operative continence and sexual function: A systematic review and meta-analysis[J]. Andrology, 2021, 9(1): 221-232. doi: 10.1111/andr.12898
[17] Walsh PC, Mostwin JL. Radical prostatectomy and cystoprostatectomy with preservation of potency. Results using a new nerve-sparing technique[J]. Br J Urology, 1984, 56(6): 694-697. doi: 10.1111/j.1464-410X.1984.tb06149.x
[18] Furrer MA, Studer UE, Gross T, et al. Nerve-sparing radical cystectomy has a beneficial impact on urinary continence after orthotopic bladder substitution, which becomes even more apparent over time[J]. BJU Int, 2018, 121(6): 935-944. doi: 10.1111/bju.14123
[19] Menon M, Shrivastava A, Bhandari M, et al. Vattikuti institute prostatectomy: technical modifications in 2009[J]. Eur Urol, 2009, 56(1): 89-96. doi: 10.1016/j.eururo.2009.04.032
[20] Wang X, Guo J, Wang L, et al. Modified completely intrafascial radical cysprostatectomy for bladder cancer: a single-center, blinded, controlled study[J]. BMC Cancer, 2021, 21(1): 887. doi: 10.1186/s12885-021-08568-z
[21] Schilling A, Friesen A. Transprostatic selective cystectomy with an ileal bladder[J]. Eur Urol, 1990, 18(4): 253-257. doi: 10.1159/000463924
[22] 王晓雄. 保留前列腺包膜在膀胱癌根治性切除术中的利弊[J]. 中华泌尿外科杂志, 2005, 26(9): 584. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMN200509006.htm
[23] Hautmann RE, Stein JP. Neobladder with prostatic capsule and seminal-sparing cystectomy for bladder cancer: a step in the wrong direction[J]. Urol Clin North Am, 2005, 32(2): 177-185. doi: 10.1016/j.ucl.2005.02.001
[24] Saad M, Moschini M, Stabile A, et al. Long-term functional and oncological outcomes of nerve-sparing and prostate capsule-sparing cystectomy: a single-centre experience[J]. BJU Int, 2020, 125(2): 253-259. doi: 10.1111/bju.14850
[25] 林天歆, 李记标, 何旺, 等. 保留前列腺侧包膜的机器人辅助根治性膀胱切除-原位回肠新膀胱术的早期疗效[J]. 中华泌尿外科杂志, 2021, 42(7): 491-496. doi: 10.3760/cma.j.cn112330-20210422-00220
[26] Klotz L. Prostate capsule sparing radical cystectomy: oncologic safety and clinical outcome[J]. Ther Adv Urol, 2009, 1(1): 43-50. doi: 10.1177/1756287209103921
[27] He W, Yang J, Gao M, et al. Pelvic reconstruction and lateral prostate capsule sparing techniques improve early continence of robot-assisted radical cystectomy with orthotopic ileal neobladder[J]. Int Urol Nephrol, 2022, 54(7): 1537-1543. doi: 10.1007/s11255-022-03214-4
[28] Mertens LS, Meijer RP, de Vries RR, et al. Prostate sparing cystectomy for bladder cancer: 20-year single center experience[J]. J Urol, 2014, 191(5): 1250-1255. doi: 10.1016/j.juro.2013.11.031
[29] Basiri A, Pakmanesh H, Tabibi A, et al. Overall survival and functional results of prostate-sparing cystectomy: a matched case-control study[J]. Urol J, 2012, 9(4): 678-684.
[30] 保文斌, 王海峰, 栾婷, 等. 女性根治性膀胱切除术后性功能障碍的研究进展[J]. 临床泌尿外科杂志, 2022, 37(3): 234-238. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202203017.htm
[31] Veskimäe E, Neuzillet Y, Rouanne M, et al. Systematic review of the oncological and functional outcomes of pelvic organ-preserving radical cystectomy(RC)compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer[J]. BJU Int, 2017, 120(1): 12-24. doi: 10.1111/bju.13819
[32] Niver BE, Daneshmand S, Satkunasivam R. Female reproductive organ-sparing radical cystectomy: contemporary indications, techniques and outcomes[J]. Curr Opin Urol, 2015, 25(2): 105-110. doi: 10.1097/MOU.0000000000000146
[33] Witjes JA, Bruins HM, Cathomas R, et al. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines[J]. Eur Urol, 2021, 79(1): 82-104. doi: 10.1016/j.eururo.2020.03.055
[34] Rocco B, Gregori A, Stener S, et al. Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy[J]. Eur Urol, 2007, 51(4): 996-1003. doi: 10.1016/j.eururo.2006.10.014
[35] Nguyen MM, Kamoi K, Stein RJ, et al. Early continence outcomes of posterior musculofascial plate reconstruction during robotic and laparoscopic prostatectomy[J]. BJU Int, 2008, 101(9): 1135-1139. doi: 10.1111/j.1464-410X.2007.07425.x
[36] Rocco B, Luciani LG, Collins J, et al. Posterior reconstruction during robotic-assisted radical cystectomy with intracorporeal orthotopic ileal neobladder: description and outcomes of a simple step[J]. J Robot Surg, 2021, 15(3): 355-361. doi: 10.1007/s11701-020-01108-0
[37] Mineo Bianchi F, Romagnoli D, D'Agostino D, et al. Posterior muscle-fascial reconstruction and knotless urethro-neo bladder anastomosis during robot-assisted radical cystectomy: Description of the technique and its impact on urinary continence[J]. Arch Ital Urol Androl, 2019, 91(1): 5-10. doi: 10.4081/aiua.2019.1.5
[38] Walsh PC. Anatomic radical prostatectomy: evolution of the surgical technique[J]. J Urol, 1998, 160(6 Pt 2): 2418-2424.
[39] Noguchi M, Kakuma T, Suekane S, et al. A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy[J]. BJU Int, 2008, 102(8): 958-963. doi: 10.1111/j.1464-410X.2008.07759.x
[40] Han KS, Kim CS. Effect of pubovesical complex reconstruction during robot-assisted laparoscopic prostatectomy on the recovery of urinary continence[J]. J Laparoendosc Adv Surg Tech A, 2015, 25(10): 814-820. doi: 10.1089/lap.2014.0584
[41] Cui J, Guo H, Li Y, et al. Pelvic floor reconstruction after radical prostatectomy: a systematic review and meta-analysis of different surgical techniques[J]. Sci Rep, 2017, 7(1): 2737. doi: 10.1038/s41598-017-02991-8
[42] Hurtes X, Rouprêt M, Vaessen C, et al. Anterior suspension combined with posterior reconstruction during robot-assisted laparoscopic prostatectomy improves early return of urinary continence: a prospective randomized multicentre trial[J]. BJU Int, 2012, 110(6): 875-883. doi: 10.1111/j.1464-410X.2011.10849.x
[43] 都兴华, 苏泽轩. 女性控尿相关功能解剖的研究进展[J]. 中国医学工程, 2009, 17(5): 346-349, 354. https://www.cnki.com.cn/Article/CJFDTOTAL-YCGC200905011.htm
[44] 刘冲, 蔡志康, 李文智, 等. 腹腔镜前列腺癌根治术控尿解剖应用基础[J/OL]. 泌尿外科杂志(电子版), 2018, 10(4): 1-3.
[45] Tuygun C, Imamoglu A, Keyik B, et al. Significance of fibrosis around and/or at external urinary sphincter on pelvic magnetic resonance imaging in patients with postprostatectomy incontinence[J]. Urology, 2006, 68(6): 1308-1312. doi: 10.1016/j.urology.2006.08.1080
[46] Desai MM, Gill IS, de Castro Abreu AL, et al. Robotic intracorporeal orthotopic neobladder during radical cystectomy in 132 patients[J]. J Urol, 2014, 192(6): 1734-1740. doi: 10.1016/j.juro.2014.06.087
[47] Almassi N, Zargar H, Ganesan V, et al. Management of challenging urethro-ileal anastomosis during robotic assisted radical cystectomy with intracorporeal neobladder formation[J]. Eur Urol, 2016, 69(4): 704-709. doi: 10.1016/j.eururo.2015.09.037
[48] Porpiglia F, Bertolo R, Manfredi M, et al. Total anatomical reconstruction during robot-assisted radical prostatectomy: implications on early recovery of urinary continence[J]. Eur Urol, 2016, 69(3): 485-495. doi: 10.1016/j.eururo.2015.08.005
[49] Hamada A, Razdan S, Etafy MH, et al. Early return of continence in patients undergoing robot-assisted laparoscopic prostatectomy using modified maximal urethral length preservation technique[J]. J Endourol, 2014, 28(8): 930-938. doi: 10.1089/end.2013.0794
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