Analysis of the Efficacy of Complete Pelvic Floor Peritoneal Reconstruction Technique in Total Cystectomy with Orthotopic Neobladder

Sheng LIU; Fei YUAN; Hongqing ZHOU; Mingsheng LIU; Donghuan ZOU; Yu LI; Zihan DAI; Guanyu CHEN; Feng GUO

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Sheng LIU, Fei YUAN, Hongqing ZHOU, Mingsheng LIU, Donghuan ZOU, Yu LI, Zihan DAI, Guanyu CHEN, Feng GUO. Analysis of the Efficacy of Complete Pelvic Floor Peritoneal Reconstruction Technique in Total Cystectomy with Orthotopic Neobladder[J]. Journal of Kunming Medical University.

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Analysis of the Efficacy of Complete Pelvic Floor Peritoneal Reconstruction Technique in Total Cystectomy with Orthotopic Neobladder

1.
Graduate School，Kunming Medical University，Kunming Yunnan 650500
2.
Department of Urology，The First People’s Hospital of Qujing，Qujing Yunnan 655000
3.
Clinical Skills Training Center，Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2024-08-07
Available Online: 2024-12-28

Abstract

Abstract

Objective To explore the application effect of complete pelvic floor peritoneal reconstruction technique in reducing the incidence of postoperative bowel obstruction and accelerating patients' postoperative recovery after laparoscopic total cystectomy with in situ neobladder. Methods A retrospective study was conducted on 51 patients who underwent this surgical procedure from January 2018 to December 2023. The patients were divided into a conventional group （n = 20） and a reconstruction group （n = 31）. The postoperative incidence of intestinal obstruction and the recovery status of the patients were analyzed to evaluate the application value of complete pelvic floor peritoneal reconstruction technology in laparoscopic radical cystectomy with orthotopic neobladder. Results The incidence rates of intestinal obstruction in the reconstruction group and the conventional group were 32.30% and 45.00%, respectively, χ²=0.844, P = 0.358, with no statistically significant （P > 0.05）. The quartiles of gastrointestinal function recovery time in the reconstruction group and the conventional group were 3（2, 4） daysd and 3.5（3, 5.75） days, Z = -2.218, P = 0.027. The quartiles of abdominal drainage timewere 12（10, 14） days and 14（12.25, 16） days, Z=-2.748, P = 0.006, The quartiles of pelvic drainage timewere 12（10, 14） d and 14（11, 16） d, Z = -2.333, P = 0.002. The quartiles of postoperative hospital stay were 18（16, 26） days and 25（ 18.25, 30.75） days, Z = -2.071, P = 0.038. All thesedifferences were statistically significant （P < 0.05）. No statistically significant differences were found in other data between the two groups: tumour staging, operation time, intraoperative blood loss, whether a gastric tube was placed, ureteral stent and catheter removal time（P > 0.05）. Conclusion The application of complete pelvic floor peritoneal reconstruction technique in laparoscopic total cystectomy with orthotopic neobladder surgery provides better protection for the intestinal tract, reduces adhesions in the surgical area, effectively promotes gastrointestinal recovery, shortens abdominal and pelvic drainage time , accelerates patient recovery, and reduces hospital stay. However, whether it can effectively reduce the incidence of postoperative intestinal obstruction still requires more data and experiments for validation.

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