Search
What are you looking for?
Start main content

Press Releases

Press Releases

https://med.cuhk.edu.hk/press-releases/study-led-by-cuhk-shows-robotic-assisted-bladder-removal-with-intracorporeal-urinary-diversion-reduces-blood-loss-and-enhances-post-operative-recovery
https://med.cuhk.edu.hk/press-releases/study-led-by-cuhk-shows-robotic-assisted-bladder-removal-with-intracorporeal-urinary-diversion-reduces-blood-loss-and-enhances-post-operative-recovery

Study led by CUHK shows robotic-assisted bladder removal with intracorporeal urinary diversion reduces blood loss and enhances post-operative recovery

Robotic-assisted radical cystectomy (RARC), the complete removal of the bladder with the use of surgical robots, has gained increasing acceptance worldwide. After the removal of the bladder, patients need to undergo a urinary diversion, such as the reconstruction of a “new bladder”. In the past, a urinary diversion had to be performed through an open approach, i.e. extracorporeal urinary diversion (ECUD). Recently, an intracorporeal urinary diversion (ICUD) approach has been introduced, and the whole procedure can be performed in a minimally invasive manner.

 

The Chinese University of Hong Kong’s (CUHK) Faculty of Medicine (CU Medicine) has led a study involving nine expert centres in Asia to understand the safety and feasibility of RARC with ICUD, in which ICUD is more complicated and technical than ECUD. Study results showed that ICUD reduced the volume of blood loss and the length of hospital stay by 22% and 12% respectively over ECUD. Meanwhile, the major complication rates were similar between the two study groups. These results have been published in the journal Annals of Surgical Oncology.

 

RARC with ICUD is regarded as one of the most challenging robotic-assisted surgeries in urology

 

Bladder cancer is the 11th most common cancer worldwide. Patients with localised muscle-invasive bladder cancer can be treated by RARC. In 2017, a number of Asian expert centres in bladder cancer, including centres in Japan, Korea, Thailand and mainland China, joined hands to form the Asian RARC Consortium. The aim of establishing this consortium is to develop an Asian RARC registry to learn more about the potential benefits and drawbacks of RARC.    

  

Urinary diversion is a major step involved in RARC, and it can be done by reconstructing an ileal conduit or a neobladder. The former is performed by using a segment of the small intestine, which directs urine through a stoma into an external collection bag. The latter is performed by using a longer segment of the small intestine, which is then reconstructed into a reservoir to replace the original bladder, so patients can urinate as usual. Urinary diversion can be done in both an extracorporeal and intracorporeal approach.

 

Being the standard of care, ECUD is performed via an open approach and will lead to a wound of 15 to 20 cm as the part of the intestine used for diversion has to be taken out through the wound to perform the reconstruction outside the body. On the other hand, ICUD is performed with a minimally invasive approach as the whole procedure is completed within the abdominal cavity. Thus, ICUD requires higher skills than ECUD.    

 

Professor Anthony Ng

Professor Anthony Ng

Dr Jeremy Teoh

Dr Jeremy Teoh

ICUD can reduce blood loss and the length of hospital stay

 

The Urology team at CU Medicine led the study which reviewed the data of 556 bladder cancer patients from the Asian RARC registry between 2007 and 2020. 55% of the patients had ICUD while 45% underwent ECUD. Comparison of the outcomes of the 2 groups showed that the blood loss of ICUD was 22% less than ECUD, while the length of hospital stay of ICUD was also 12% shorter than ECUD. Meanwhile, the major complication rates were similar among the 2 groups. Details are as follows:

 

ICUD group

(307 patients)

ECUD group

(249 patients)

Blood loss (mL)

423

541

Length of hospital stay (days)

16

18

Major complication rate (%)

15

17

 

Dr. Jeremy Yuen Chun TEOH, Assistant Professor from the Division of Urology, Department of Surgery at CU Medicine, remarked, “Our study is impactful as it demonstrates that an intracorporeal approach for urinary diversion is equally safe and feasible as an extracorporeal one. It also generates additional benefits of less blood loss and shorter hospitalisation. We can say that RARC plus ICUD could potentially be the best possible minimally invasive approach in treating muscle-invasive bladder cancer.”    

More Press Releases

CU Medicine Studies Highlight Smoking as a Contributing Factor for Bladder Cancer and  Develop an International Collaborative Consensus on En Bloc Resection to Treat the Disease

CU Medicine Studies Highlight Smoking as a Contributing Factor for Bladder Cancer and Develop an International Collaborative Consensus on En Bloc Resection to Treat the Disease

Research
CUHK study demonstrates a significant benefit from en bloc resection of bladder tumours in reducing tumour recurrence over conventional transurethral resection

CUHK study demonstrates a significant benefit from en bloc resection of bladder tumours in reducing tumour recurrence over conventional transurethral resection

Research
CUHK and HKBU Launch Spermine Risk Score for Prostate Cancer Diagnosis

CUHK and HKBU Launch Spermine Risk Score for Prostate Cancer Diagnosis

Research
CUHK Identifies Outcome Indicators for Benign Prostatic Hyperplasia Patients Receiving Prostatic Artery Embolisation

CUHK Identifies Outcome Indicators for Benign Prostatic Hyperplasia Patients Receiving Prostatic Artery Embolisation

Research
CUHK Successfully Conducted the World’s First Multi-Specialty Clinical Trial Using the Next Generation Single Port Robotic Surgical System

CUHK Successfully Conducted the World’s First Multi-Specialty Clinical Trial Using the Next Generation Single Port Robotic Surgical System

Surgical advancement
CU Medicine Survey Shows Global Urological Services have been Significantly Deferred due to COVID-19 Pandemic

CU Medicine Survey Shows Global Urological Services have been Significantly Deferred due to COVID-19 Pandemic

Research
CUHK Opens S.H. Ho Urology Centre to Promote Earlier Diagnosis and Management of Prostate Cancer to the Territory

CUHK Opens S.H. Ho Urology Centre to Promote Earlier Diagnosis and Management of Prostate Cancer to the Territory

Clinical service
CUHK Assessed and Treated Over 300 Young Ketamine Abusers with Urinary Tract Dysfunction Latest Research Reveals Effectiveness of Integrated Anti-inflammatory Therapy

CUHK Assessed and Treated Over 300 Young Ketamine Abusers with Urinary Tract Dysfunction Latest Research Reveals Effectiveness of Integrated Anti-inflammatory Therapy

Research
CU Medicine finds benign prostatic hyperplasia patients suffer from up to five times the risk of urological complications after COVID-19 infection

CU Medicine finds benign prostatic hyperplasia patients suffer from up to five times the risk of urological complications after COVID-19 infection

Research
CU Medicine and Olympus Corporation sign MoU to develop  innovative endoscopy and laparoscopy technologies

CU Medicine and Olympus Corporation sign MoU to develop innovative endoscopy and laparoscopy technologies

Surgical advancement
CU Medicine proves a new ultrasound-guided endoscopic procedure has higher success and shorter procedural time for treating malignant distal biliary obstruction

CU Medicine proves a new ultrasound-guided endoscopic procedure has higher success and shorter procedural time for treating malignant distal biliary obstruction

Research
CUHK introduces a new modular robotic surgery system in the Greater China region Initial trials in radical prostatectomy show satisfactory outcomes

CUHK introduces a new modular robotic surgery system in the Greater China region Initial trials in radical prostatectomy show satisfactory outcomes

Surgical advancement
CU Medicine first in Asia to perform one-stage hybrid aortic arch surgery on patients with multi-segment thoracic aortic diseases using novel device

CU Medicine first in Asia to perform one-stage hybrid aortic arch surgery on patients with multi-segment thoracic aortic diseases using novel device

Research
CU Medicine and International Surgeons Suggest Patients with Positive COVID-19 Results Should Delay Surgery for Seven Weeks to Reduce Death Risk

CU Medicine and International Surgeons Suggest Patients with Positive COVID-19 Results Should Delay Surgery for Seven Weeks to Reduce Death Risk

International collaboration
Results of the First 3,500 Participants of the CUHK Jockey Club Multi-Cancer Prevention Programme Demonstrate that “One-stop Multi-Cancer Screening” is Effective

Results of the First 3,500 Participants of the CUHK Jockey Club Multi-Cancer Prevention Programme Demonstrate that “One-stop Multi-Cancer Screening” is Effective

Health Campaign
CUHK Successfully Performed World’s First Colorectal Endoscopic Submucosal Dissection  Using Flexible Endoscopic Robotic System

CUHK Successfully Performed World’s First Colorectal Endoscopic Submucosal Dissection Using Flexible Endoscopic Robotic System

Surgical advancement
CUHK Successfully Conducts Asia-Pacific’s First Hybrid Operating Room Non-invasive Bronchoscopic Microwave Ablation to Treat Lung Cancer

CUHK Successfully Conducts Asia-Pacific’s First Hybrid Operating Room Non-invasive Bronchoscopic Microwave Ablation to Treat Lung Cancer

Surgical advancement
CUHK Deepening Ties with World Leading Institutes for Transdisciplinary Medical Robotics Research to Reshape the Future of Diagnosis and Treatment

CUHK Deepening Ties with World Leading Institutes for Transdisciplinary Medical Robotics Research to Reshape the Future of Diagnosis and Treatment

International collaboration
CUHK Pioneers Early Lung Cancer Treatment with Hybrid Operating Room Image Guided Electromagnetic Navigation Bronchoscopy

CUHK Pioneers Early Lung Cancer Treatment with Hybrid Operating Room Image Guided Electromagnetic Navigation Bronchoscopy

Surgical advancement
CUHK-DGIST-ETH Zurich Establish Joint Laboratory on Nano-technology for Gastrointestinal and Cardiovascular Diseases

CUHK-DGIST-ETH Zurich Establish Joint Laboratory on Nano-technology for Gastrointestinal and Cardiovascular Diseases

International collaboration
World’s First Large-scale Epidemiological Survey on Adolescents by CUHK Reveals Abuse of Methamphetamine Associated with Increased Risk of Developing Lower Urinary Tract Symptoms

World’s First Large-scale Epidemiological Survey on Adolescents by CUHK Reveals Abuse of Methamphetamine Associated with Increased Risk of Developing Lower Urinary Tract Symptoms

Clinical service
CUHK’s New Prostatic Artery Embolization Shows 90% Success Rate in Relieving Symptoms of Benign Prostatic Hyperplasia

CUHK’s New Prostatic Artery Embolization Shows 90% Success Rate in Relieving Symptoms of Benign Prostatic Hyperplasia

Clinical service
CUHK Introduces High Frequency Oscillations to Determine Resection Margin Increases the Effectiveness of Complex Epilepsy Surgery by around 30%

CUHK Introduces High Frequency Oscillations to Determine Resection Margin Increases the Effectiveness of Complex Epilepsy Surgery by around 30%

Surgical advancement
CUHK Succeeds in Treating Gastroesophageal Reflux Disease by Implantable Pulse Generator

CUHK Succeeds in Treating Gastroesophageal Reflux Disease by Implantable Pulse Generator

Surgical advancement
CUHK-PWH Hybrid Cardiovascular Operating Theatre Officially Opens Multi-functional Setting Enhances Surgical Outcomes

CUHK-PWH Hybrid Cardiovascular Operating Theatre Officially Opens Multi-functional Setting Enhances Surgical Outcomes

Clinical service
Bowel Cancer Will Become Top Cancer in Hong Kong CUHK Introduces Colon Pill Camera to Prevent Bowel Cancer

Bowel Cancer Will Become Top Cancer in Hong Kong CUHK Introduces Colon Pill Camera to Prevent Bowel Cancer

Surgical advancement
CUHK's Youth Urological Treatment Centre Opens Today Territory's First Centre to Provide Urological Assessment and Treatment to Young Drug Abusers

CUHK's Youth Urological Treatment Centre Opens Today Territory's First Centre to Provide Urological Assessment and Treatment to Young Drug Abusers

Donation
CUHK Pioneers Surgical Treatment of Deep Brain Stimulation for Tardive Dystonia in HK

CUHK Pioneers Surgical Treatment of Deep Brain Stimulation for Tardive Dystonia in HK

Surgical advancement
CUHK Discovers Drug Dosage Brings Negative Impact on Bladder Function among Young People

CUHK Discovers Drug Dosage Brings Negative Impact on Bladder Function among Young People

Research

Our Expert List

Many experts under the Faculty of Medicine are available for media interview.
Please click here for the expert list or contact us.