Editing Cystectomy (section)

=== Technique ===
* '''For cisplatin-eligible patients with MIBC patients that have chosen partial cystectomy and pelvic lymphadenectomy, perioperative chemotherapy should be offered.[https://pubmed.ncbi.nlm.nih.gov/28456635/ ★]'''
** '''Pelvic lymph node dissection should be performed at the time of partial cystectomy[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737737/ ★]'''
*'''Random bladder biopsies (plus prostatic urethral biopsy) should be performed prior to partial cystectomy to rule out occult disease [i.e. CIS][https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737737/ ★]'''
*Cystotomy is performed in an area away from the tumor.
* The tumor is then excised including the underlying bladder wall and perivesical fat with a mucosal margin of 1 to 2 cm and confirmation of resection adequacy with frozen section analysis. If necessary, the ureteral orifice or intramural ureter can be excised and a reimplantation performed.
* After excision of the tumor the cystotomy is closed with 2-0 polyglactin suture in 2 or 3 layers, and an instillation of fluid via a Foley catheter is performed to ensure a watertight closure.
* Copious warm water irrigation of the surgical field is performed to minimize the possibility of pelvic seeding.
* A closed suction drain should be placed and the cystotomy closure interrogated with a cystogram on postoperative day 7 before removal of the Foley catheter.