Abstract
We compared the surgical and oncological outcomes of laparoscopic and open radical cystectomy for bladder cancer.
From January 1999, 196 radical cystectomies were performed in our institute. One hundred and three cases were done by open procedure (ORC : Open Radical Cystectomy), but 93 were laparoscopically (LRC : Laparoscopic Radical Cystectomy). There was no significant different between ORC and LRC in urinary diversion methods. Median follow-up were 49 months (LRC) and 78 months (ORC). The procedures of laparoscopic radical cystectomy were done by 4 ports methods and bladder was extracted through perineal wound in male or vagina.
Median operative time was significantly longer in LRC {487min (LRC), 391 min (ORC) }. However, mean blood loss (670ml, 1484ml) were significantly less in the LRC. Postoperative oral intake (1 day, 5 day) was started significantly earlier and hospital stay (34 day, 49 day) were significant shorter in the LRC. Rate of major postoperative complications were not significal different between LRC and ORC, but the incidence were lower in LRC. The 5 year cancer-specific survival ratio in the two groups were comparable (LRC 85%, ORC 77%).
In conclusion, the laparoscopic approach provides the benefit of lesser blood loss in patients undergoing radical cystectomy. The oncological outcome is comparable to that of ORC. LRC is a useful and safe procedure.
