COMPARISON OF EXTRAPERITONEAL AND TRANSPERITONEAL RADICAL CYSTOPROSTATECTOMY IN TERMS OF FIRST 30 DAYS OUTCOMES

  • Mudassar Sajjad Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
  • Qamar Zia *Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Haroon Sabir Pakistan Naval Ship Shifa Hospital, Karachi Pakistan
  • Faran Kiani Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Nawaz Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Sohail Razzaq Combined Military Hospital Sialkot/National University of Medical Sciences (NUMS) Pakistan
  • Bilal Habib Pakistan Institute of Medical Sciences, Islamabad Pakistan
Keywords: Bladder, Bladder neoplasm, Cystectomy, Cysto-prostatectomy, Ileal conduits, Ureterostomy, Urinary diversion

Abstract

Objective: To compare the first 30-day outcomes of Trans-peritoneal and Extra-peritoneal Radical cysto-prostatectomy.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Mar 2015 to Mar 2019.
Methodology: A total of 100 patients who underwent Radical cystoprostatectomy were observed in two groups either by extra or trans-peritoneal approach. Patients diagnosed with carcinoma urinary bladder (both muscle and non-muscle invasive) vetted through multidisciplinary meeting, with or without neo-adjuvant chemotherapy were included. Patients undergoing salvage cystectomy or any previous open abdomino-pelvic surgery were excluded. The standard techniques were used for both approaches. Variables under study were recorded for first 30-day-followup period.

Results: The mean age was 59.9 ± 7.231 years (range=34-80). In extra-peritoneal group the mean duration of surgery was 5.6 ± 1.16 hours comparing to 7.2 ± 1.34 hours in the trans-peritoneal group. Statistically significant trend was also noted in the favour of extra-peritoneal group for stay in Intensive care in post-operative period (3.00 ± 1.19 days/4.77 ± 1.20, p<0.001) as well total stay in the hospital (6.06 ± 2.8 days/ 11.74 ± 4.17, p<0.001). Overall comparison of total number of complications as per Clavien-Dindo system in both groups was insignificant (p=0.136), however a significant trend in favour of extraperitoneal group was noted with respect to major wound dehiscence as well rate of blood transfusion (p<0.001).

Conclusion: Extra-peritoneal approach showed a favourable trend in terms of operative time and early recovery after radical cysto-prostatectomy.

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Author Biography

Qamar Zia, *Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan

MBBS, MRCS (Ed), FCPS (Pak), FRCS (Eng), FRCS ( Urol)

Leutenant Colonel and Assistant professor of Urology

Combined Military Hospital Lahore

 

Published
2021-08-26
How to Cite
Sajjad, M., Zia, Q., Sabir, H., Kiani, F., Nawaz, M., Razzaq, S., & Habib, B. (2021). COMPARISON OF EXTRAPERITONEAL AND TRANSPERITONEAL RADICAL CYSTOPROSTATECTOMY IN TERMS OF FIRST 30 DAYS OUTCOMES. PAFMJ, 71(4), 1282-87. https://doi.org/10.51253/pafmj.v71i4.4136
Section
Original Articles

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