{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:06:53Z","timestamp":1784700413324,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Urethra\u2013neobladder anastomosis following laparoscopic radical cystectomy combined with an ileal orthotopic neobladder is a pivotal step that significantly influences postoperative urinary continence, urodynamic performance, and the risk of surgical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aims to evaluate the effects of a modified urethral dragging-and-adhesion anastomosis technique on postoperative urodynamic parameters, urinary continence recovery, and immune function, with emphasis on its potential benefits in reducing surgical trauma, enhancing functional outcomes, and mitigating immune suppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on 55 patients with bladder cancer who underwent laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction at Jiangxi Provincial People's Hospital (35 cases) and the Second Affiliated Hospital of Nanchang University (20 cases) between June 2016 and January 2021. Of these, 30 patients received urethral dragging-and-adhesion anastomosis (observation group), while 25 patients underwent conventional interrupted anastomosis (control group). The study compared operative time and intraoperative blood loss between the two groups and evaluated postoperative urodynamic parameters, including maximum bladder capacity, postvoid residual, maximum flow rate (Q-max), and average flow rate (Q-ave). In addition, this study evaluated the recovery of daytime and nighttime urinary control in patients 3 months, 1 year, and 2 years after the surgery, along with immune function indicators 1 week after the surgery, namely, the proportions of CD3+, CD4+, and CD8+ T cells and the CD4+\/CD8+ ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were no significant differences in preoperative general data or immune-related parameters between the two groups. The observation group demonstrated significantly shorter operative times (279.80\u2009\u00b1\u200945.32\u2005min vs. 382.60\u2009\u00b1\u200945.94\u2005min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) and urethral anastomosis times (18.37\u2009\u00b1\u20097.05\u2005min vs. 61.80\u2009\u00b1\u200911.35\u2005min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) compared with the control group, in addition to reduced intraoperative blood loss (274.00\u2009\u00b1\u200985.48\u2005mL vs. 336.80\u2009\u00b1\u200972.44\u2005mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). No statistically significant differences were observed in urodynamic parameters between the two groups at 3 months, 1 year, or 2 years postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Regarding urinary continence recovery, no significant differences were observed between the observation and control groups in daytime and nighttime continence rates at any postoperative time point (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Immune function tests revealed that the observation group had significantly higher postoperative levels of CD3+ T cells (57.63\u2009\u00b1\u20093.41% vs. 53.68\u2009\u00b1\u20093.05%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01), CD4+ T cells (28.43\u2009\u00b1\u20092.66% vs. 24.56\u2009\u00b1\u20092.53%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) and an increased CD4+\/CD8+ ratio (0.98\u2009\u00b1\u20090.15 vs. 0.83\u2009\u00b1\u20090.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01) compared with the control group. No significant difference was observed in CD8+ T-cell levels between the two groups (29.30\u2009\u00b1\u20093.04% vs. 29.72\u2009\u00b1\u20091.43%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). In addition, both groups showed significant postoperative reductions in CD3+, CD4+, and CD8+ T-cell counts, and in the CD4+\/CD8+ ratio, compared to preoperative levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Urethral dragging-and-adhesion anastomosis is a safe and effective modified technique for urethral reconstruction during laparoscopic radical cystectomy with an ileal orthotopic neobladder. It enables speedy surgical completion and urethral anastomosis while preserving urodynamic and urinary continence functions comparable to those of traditional methods. In addition, it may contribute to better preservation of patients' immune function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1874547","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:54:20Z","timestamp":1784699660000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy evaluation of urethral dragging-and-adhesion anastomosis in ileal orthotopic neobladder reconstruction following laparoscopic radical cystectomy: a dual-center retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Lie Yu","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Urology, Jiangxi Provincial People\u2019s Hospital (The First Affiliated Hospital of Nanchang Medical College)","place":["Nanchang, China"]},{"name":"Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin Chang","family":"Zou","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing Wen","family":"Luo","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai Chao","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zun Wei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology, Jiangxi Provincial People\u2019s Hospital (The First Affiliated Hospital of Nanchang Medical College)","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang Da","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Urology, Second Affiliated Hospital of Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/j.euo.2022.10.003","article-title":"Epidemiology, screening, and prevention of bladder cancer","volume":"5","author":"Lobo","year":"2022","journal-title":"Eur Urol Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1038\/s41571-023-00744-3","article-title":"Global trends in the epidemiology of bladder cancer: challenges for public health and clinical practice","volume":"20","author":"van Hoogstraten","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1119374","DOI":"10.3389\/fpubh.2023.1119374","article-title":"Trends and risk factors of global incidence, mortality, and disability of genitourinary cancers from 1990 to 2019: systematic analysis for the Global Burden of Disease Study 2019","volume":"11","author":"Tian","year":"2023","journal-title":"Front Public Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.eururo.2021.08.010","article-title":"European Association of Urology guidelines on non-muscle-invasive bladder cancer (ta, T1, and carcinoma in situ)","volume":"81","author":"Babjuk","year":"2022","journal-title":"Eur Urol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1590\/S1677-5538.IBJU.2021.0259","article-title":"Challenging dilemmas of low grade, non-invasive bladder cancer: a narrative review","volume":"48","author":"Korkes","year":"2022","journal-title":"Int Braz J Urol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1038\/s41585-022-00578-1","article-title":"Recurrence mechanisms of non-muscle-invasive bladder cancer\u2014a clinical perspective","volume":"19","author":"Teoh","year":"2022","journal-title":"Nat Rev Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"93.e1","DOI":"10.1016\/j.clgc.2021.08.003","article-title":"Radical cystectomy vs. radiotherapy in urothelial bladder cancer in elderly and very elderly patients","volume":"20","author":"Horlemann","year":"2022","journal-title":"Clin Genitourin Cancer"},{"key":"B8","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1159\/000535032","article-title":"Laparoscopic radical cystectomy with ileal orthotopic neobladder for bladder cancer: current indications and outcomes","volume":"108","author":"Guo","year":"2024","journal-title":"Urol Int"},{"key":"B9","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1097\/MOU.0000000000001016","article-title":"Comparative performance of the different orthotopic urinary diversions","volume":"32","author":"Sheybaee Moghaddam","year":"2022","journal-title":"Curr Opin Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5785","DOI":"10.1245\/s10434-024-15396-5","article-title":"Long-Term outcomes of orthotopic neobladder versus ileal conduit urinary diversion in robot-assisted radical cystectomy (RARC): multicenter results from the Asian RARC consortium","volume":"31","author":"Wong","year":"2024","journal-title":"Ann Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s11701-020-01174-4","article-title":"Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review","volume":"15","author":"Tanneru","year":"2021","journal-title":"J Robot Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"9209","DOI":"10.1245\/s10434-021-10295-5","article-title":"Perioperative outcomes of robot-assisted radical cystectomy with intracorporeal versus extracorporeal urinary diversion","volume":"28","author":"Teoh","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1016\/j.eururo.2024.01.018","article-title":"Robot-assisted radical cystectomy with totally intracorporeal urinary diversion versus open radical cystectomy: 3-year outcomes from a randomised controlled trial","volume":"85","author":"Mastroianni","year":"2024","journal-title":"Eur Urol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2909","DOI":"10.2147\/CMAR.S288673","article-title":"A novel neobladder-urethral drag-and-bond anastomosis technique during laparoscopic radical cystectomy for ileal orthotopic neobladder: surgical technique and initial research","volume":"13","author":"Yu","year":"2021","journal-title":"Cancer Manag Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1159\/000517787","article-title":"Complication rate after radical cystectomy Depends on the surgical technique and patient\u2019s clinical status","volume":"106","author":"Adamczyk","year":"2022","journal-title":"Urol Int"},{"key":"B16","doi-asserted-by":"publisher","first-page":"67","DOI":"10.21037\/tau-21-1076","article-title":"Systematic review and meta-analysis on laparoscopic cystectomy in bladder cancer","volume":"11","author":"Zhu","year":"2022","journal-title":"Transl Androl Urol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12885-020-07748-7","article-title":"Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer","volume":"21","author":"Porreca","year":"2021","journal-title":"BMC Cancer"},{"key":"B18","doi-asserted-by":"publisher","first-page":"207","DOI":"10.5114\/wiitm.2021.105572","article-title":"Our initial experience with the three layers with three-port approach for laparoscopic radical cystectomy","volume":"17","author":"Wang","year":"2022","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"key":"B19","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/j.asjsur.2021.08.022","article-title":"Propensity score-matched analysis for ileal conduit and orthotopic neobladder intracorporeally accomplished following laparoscopic radical cystectomy","volume":"45","author":"Wei","year":"2022","journal-title":"Asian J Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2525","DOI":"10.1007\/s00345-020-03484-6","article-title":"Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladder cancer: a multicentre observational study","volume":"39","author":"Tostivint","year":"2021","journal-title":"World J Urol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"300","DOI":"10.22037\/uj.v19i.7088","article-title":"A new technique for continent urinary diversion: initial experience and description of the technique","volume":"19","author":"Del Biondo","year":"2022","journal-title":"Urol J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.15182","article-title":"Carcinoma arising in ileal conduit or orthotopic ileal neobladder reconstruction: a 20-year single institute experience","volume":"85","author":"Collins","year":"2024","journal-title":"Histopathology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1007\/s10147-020-01677-y","article-title":"Atypical oncologic failure after laparoscopic and robot-assisted radical cystectomy at a single institution","volume":"25","author":"Kubota","year":"2020","journal-title":"Int J Clin Oncol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.ajur.2020.06.002","article-title":"Survival after radical cystectomy for bladder cancer: multicenter comparison between minimally invasive and open approaches","volume":"7","author":"Xie","year":"2020","journal-title":"Asian J Urol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.euf.2021.06.004","article-title":"Robot-assisted versus open radical cystectomy in bladder cancer: an economic evaluation alongside a multicentre comparative effectiveness study","volume":"8","author":"Michels","year":"2022","journal-title":"Eur Urol Focus"},{"key":"B26","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1590\/S1677-5538.IBJU.2022.0417","article-title":"Reproducibility of a modified posterior reconstruction during robotic intracorporeal neobladder reconfiguration","volume":"49","author":"Rocco","year":"2022","journal-title":"Int Braz J Urol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1007\/s11701-020-01108-0","article-title":"Posterior reconstruction during robotic-assisted radical cystectomy with intracorporeal orthotopic ileal neobladder: description and outcomes of a simple step","volume":"15","author":"Rocco","year":"2021","journal-title":"J Robot Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"S51","DOI":"10.4103\/jcrt.JCRT_538_17","article-title":"Modified U-shaped ileal neobladder designed for facilitating neobladder-urethral anastomosis in extracorporeal reconstruction after robotic-assisted radical cystectomy","volume":"15","author":"Hu","year":"2019","journal-title":"J Cancer Res Ther"},{"key":"B29","doi-asserted-by":"publisher","first-page":"313","DOI":"10.23736\/S2724-6051.21.04354-8","article-title":"Urethral fixation technique improves urinary continence recovery in men undergoing open radical cystectomy and ileal orthotopic neobladder","volume":"74","author":"Ficarra","year":"2022","journal-title":"Minerva Urol Nephrol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"802","DOI":"10.3390\/jpm13050802","article-title":"Robot-Assisted radical cystectomy with modified vesica ileale padovana (VIP) neobladder configuration using a hybrid approach: initial experience","volume":"13","author":"Shimizu","year":"2023","journal-title":"J Pers Med"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e20","DOI":"10.1016\/j.urology.2021.07.001","article-title":"Vaginal complications after radical cystectomy for bladder cancer: a systematic review","volume":"156","author":"Richter","year":"2021","journal-title":"Urology"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2615","DOI":"10.1007\/s11255-024-04015-7","article-title":"The clinical study of urinary flow parameters after drag-and-bond anastomosis for ileal orthotopic neobladder reconstruction","volume":"56","author":"Luo","year":"2024","journal-title":"Int Urol Nephrol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"983","DOI":"10.3892\/etm.2016.3404","article-title":"Effects of laparoscopic radical gastrectomy and the influence on immune function and inflammatory factors","volume":"12","author":"Ma","year":"2016","journal-title":"Exp Ther Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2692","DOI":"10.3390\/cancers12092692","article-title":"Prognostic and predictive value of tumor-infiltrating immune cells in urothelial cancer of the bladder","volume":"12","author":"van Wilpe","year":"2020","journal-title":"Cancers (Basel)"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1874547\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:54:22Z","timestamp":1784699662000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1874547\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":34,"alternative-id":["10.3389\/fsurg.2026.1874547"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1874547","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1874547"}}