Outcomes and Complications of Simultaneous Laparoscopic Cystectomy and Laparoscopic Nephroureterectomy with Umbilical Reduced Port Surgery

Objective: In recent years, although reduced port surgeries (RPS) have been reported for many urological diseases,there have been no reports regarding simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomywith umbilical RPS. Therefore, the aim of this study was to evaluate outcomes and complications of simultaneouslaparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS. Methods: We performeda preliminary case series of 4 patients with synchronous upper urinary tract (UUT) tumor and invasive bladder cancerwho underwent simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPSbetween 2014 and 2017 at our hospital. Demographic data, pathologic features, the surgical technique, and outcomeswere retrospectively analyzed. Result: All 4 patients were men whose median age was 79 years (range 65-85 years) andmedian body mass index was 24.2 kg/m2 (range 21.5-27.3 kg/m2). The laparoscopic approach was technically successfulin all 4 patients without the need for open conversion. The median total operative time was 434 minutes (range 372-481minutes). The median estimated blood loss was 773 ml (range 153-923 ml), median interval to resuming oral intakewas 2 days (range 1-7 days), and median hospital stay was 16 days (range 13-20 days). Conclusion: The reduced portapproach is technically feasible in terms of many outcome measures, with significant cosmetic advantages. This methodcan be performed safely and recommended as a viable option for patients with concomitant UUT and bladder cancer.