Background and purpose: Bladder cancer radical surgery is difficult with many perioperative complications

and the learning curve is long. To introduce the clinical application of complete retrograde radical cystectomy and consequent abdominal cavity reconstruction in male bladder cancer

and to provide a standardized surgical procedure with minimum perioperative complications and short learning curve. Methods: From Apr. 2012 to Apr. 2013

110 cases of male patients with bladder cancer received this procedure in our department

with a median age of 64 (35-83) years; Preoperative characters

surgical parameters

perioperative complications

pathology

long-term complications and short-term prognosis were collected and analyzed. Results: The median number of lymph nodes resected in operation was 12 (8-16); Neurovascular bundles were reserved bilaterally in 65 cases

and unilaterally in 31 cases; The complete procedure including urinary diversion took 4.4 (2.2-6.0) hours

with a median time of opened abdominal cavity of 43.0 (5.0-75.0) minutes; The median blood loss was 140.0 (50.0-600.0) mL

and 4 patients needed transfusion; Median time of abdominal and pelvic drainage was 10.0 (6.0-15.0) days

the median gastrointestinal recovery time was 2.5 (1.0-12.0) days

and the median postoperative hospital stay was 17.0 (10.0-39.0) days; Grade 2 Clavien-Dindo classification (CDC) of surgical complications that required medical intervention were found in 19 cases

CDC grade 3 or above were found in 8 cases; Mild to moderate postoperative ileus happened in 5 cases

all recovered in median 2 (1-4) weeks with supportive treatments; There were no perioperative deaths. All samples were sent to pathological analyses. After a median follow-up of 9 (3-15) months

no complications of or above CDC grade 3 happened

and there were no recurrence. Conclusion: Complete retrograde radical cystectomy in male bladder cancer provided clear anatomical approach

reliable neurovascular bundle preservation

less blood loss

limited abdominal organs disturbance and better surgical exposure; With respect to tumor control

more peritoneal was retained for subsequent abdominal cavity reconstruction. The introduced procedure effectively speeded up gastrointestinal recovery

reduced postoperative complications

especially the incidence of ileus and its severity

and shortened hospital stay. The learning curve of this procedure for urologists was short

and further investigation was warranted.