1168 CAN VAGINAL-SPARING CYSTECTOMY BE SAFELY ATTEMPTED IN ALL WOMEN UNDERGOING RADICAL CYSTECTOMY? A SINGLE INSTITUTION STUDY OF PERIOPERATIVE AND ONCOLOGIC OUTCOMES

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You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion1 Apr 20121168 CAN VAGINAL-SPARING CYSTECTOMY BE SAFELY ATTEMPTED IN ALL WOMEN UNDERGOING RADICAL CYSTECTOMY? A SINGLE INSTITUTION STUDY OF PERIOPERATIVE AND ONCOLOGIC OUTCOMES Michael Large, Sandip Prasad, Amit Patel, Gautam Jayram, Cory Ganshert, and Gary Steinberg Michael LargeMichael Large Chicago, IL More articles by this author , Sandip PrasadSandip Prasad Chicago, IL More articles by this author , Amit PatelAmit Patel Chicago, IL More articles by this author , Gautam JayramGautam Jayram Chicago, IL More articles by this author , Cory GanshertCory Ganshert Chicago, IL More articles by this author , and Gary SteinbergGary Steinberg Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1392AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Little is known regarding the perioperative and oncologic outcomes following vaginal-sparing radical cystectomy (VS-RC). METHODS Between 1/2005 and 12/2009, radical cystectomy was performed for bladder urothelial cell carcinoma in 113 consecutive women. At the University of Chicago, VS-RC is attempted in all women and only aborted if surgeon GDS is unable to propagate a natural surgical plane between the posterior bladder and anterior vagina. RESULTS Of the 113 women who underwent open radical cystectomy by GDS, 94 had VS-RC. Mean age for VS-RC patients was 69.1 years, vs. 73.4 years for non-vaginal-sparing cystectomy (NVS-RC) patients. Mean hospital stay, estimated blood loss, preoperative clinical stage, mean lymph nodes removed, incidence of Clavien grade ≥3 complications, and local recurrence rates did not differ between the two groups. Patients undergoing NVS-RC were more likely to have pathologic stage ≥T3 (78.9% vs. 44.7%, p=0.01), and node-positive disease (58% vs. 26.6%, p=0.03). Frequency of positive posterior surgical margins did not differ between the two groups. Among pathologic stage ≥T3 patients, 42 underwent VS-RC vs. 15 who underwent NVS-RC, and Kaplan-Meier local recurrence-free survival did not differ (p=0.61). CONCLUSIONS Vaginal-sparing radical cystectomy has similar perioperative outcomes versus non-vaginal-sparing cystectomy. The presence of a natural posterior plane may be used to determine viability of vaginal sparing, and the rate of positive posterior surgical margins and local recurrence-free survival do not appear to differ between vaginal- and non-vaginal-sparing patients. Larger studies, multiple surgeons, and both robotic and open approaches are needed to confirm these preliminary findings. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187 Issue 4S April 2012 Page: e473-e474 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Metrics Author Information Michael Large Chicago, IL More articles by this author Sandip Prasad Chicago, IL More articles by this author Amit Patel Chicago, IL More articles by this author Gautam Jayram Chicago, IL More articles by this author Cory Ganshert Chicago, IL More articles by this author Gary Steinberg Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...