TITLE:
Transperitoneal Laparoscopic Cystoprostatectomy for Muscle Invasive Bladder Cancer: Results and Oncologic Outcomes in a Single Center in Douala Cameroon
AUTHORS:
Cyril Kamadjou, Divine Enoru Eyongeta, Annie Wadeu Kameni, Herve Moby Mpah, Justin Kamga, Bertin Njinou Ngninkeu, Fru Angwafo
KEYWORDS:
Laparoscopic Radical Cystectomy, Bladder Cancer, Overall Survival, Urinary Diversion
JOURNAL NAME:
Surgical Science,
Vol.13 No.11,
November
30,
2022
ABSTRACT: Background and Aim: Radical cystectomy is the treatment of choice for muscle-invasive bladder
cancer. Although open surgery is currently the gold standard for this procedure,
it can also be done via laparoscopy. We aimed to evaluate the oncologic results
and the place of laparoscopic cystectomy in the management of bladder cancer in
a single urology center in Douala, Cameroon. Patients and Methods: This
is a prospective, single-center study carried out from 2015 to 2019. We
included 12 patients (ten men and two women) with bladder cancer who underwent
total radical laparoscopic transperitoneal cystectomy with ilio-obturator lymph
node dissection. Data on patients’ demographic characteristics, pre-operative
and postoperative clinical parameters and workup results, and surgical outcomes
were collected to determine the overall survival using a Kaplan-Meier curve. Results: We recruited ten men and two women with a median age of 61.5 [52.8 - 68.5] years. The mean tumor diameter was 3.75 ± 1.06
cm. Three (25%) patients received adjuvant chemotherapy while eight did not. The
mean surgery duration was 242 ± 45.85
minutes. Blood vessels and nerves were preserved in four (33.33%) patients during
surgery. Transitional cell carcinoma was found in 10 (83.33%)
patients while epidermoid carcinoma was found in two (16.67%) patients.
Metastasis occurred in four (33.33%) patients while the tumor recurred in two
(16.67%) patients who later died. Bricker’s ileal conduit urinary diversion was
performed in 10 (83.33%) patients while the Studer neobladder was used in two
(16.67%) patients. The mean duration of hospitalization was 6 ± 1.48
days. Only one patient (8.33%) developed a postoperative complication. Six
(50%) of the patients died while six survived. The median overall survival was
486 days and the five-year overall survival rate was 46.47%. Conclusion: Laparoscopic cystectomy is a mini-invasive technique associated with good
cancer control. When performed by well-trained staff using specialized
equipment, it can be a safe and effective method of managing muscle-invasive
bladder cancer.