Laparoscopic technique
Under magnification, the surgeon marks the boundaries of the tumor (using cystoscopy before surgery), excises the wall of the bladder with 1–2 cm of healthy tissue and adjacent tissue; in the case of a urachus tumor, a single block with the urachus and navel; the defect is sutured with a double-row continuous suture on a catheter. Extended lymph node dissection along the iliac vessels is performed through the same punctures. The drug is removed in a container with the histology of the resection margins. The catheter is removed 7–10 days after cystography; if the orifice is involved, the ureter is reimplanted with the installation of a stent.
When can you save the bubble?
Bladder resection is indicated for a single muscle-invasive tumor located away from the neck and triangle (dome, lateral walls, diverticulum, urachus tumor), without carcinoma in situ in the remaining mucosa and without a history of multiple recurrences. 5–10% of patients meet these criteria. If the indications are followed, the results are comparable to cystectomy, and bladder function and sexual function are preserved.
Observation
The remaining mucosa remains at risk of new tumors, so cystoscopy every 3 months in the first 2 years, urine cytology and MSCT are required; in case of relapse, TUR or cystectomy is performed. The capacity of the bladder after resection is restored within several months.
