Prospective study comparing laparoscopic and open radical cystectomy: Surgical and oncological results

• Published in: Actas urológicas españolas (English ed.) 2018-03, Vol.42 (2), p.94-102
• Main Authors: Esquinas, C., Alonso, J.M., Mateo, E., Dotor, A., Martín, A.M., Dorado, J.F., Arance, I., Angulo, J.C.
• Format: Article
• Language: English
• Subjects: Bladder cancer; Cistectomía radical; Cáncer de vejiga; Laparoscopia; Laparoscopy; Radical cystectomy
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/j.acuroe.2017.12.004

Laparoscopic radical cystectomy with lymphadenectomy and urinary diversion is an increasingly widespread operation. Studies are needed to support the oncological effectiveness and safety of this minimally invasive approach. A non-randomized, comparative prospective study between open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC) was conducted in a university hospital. The main objective was to compare cancer-specific survival. The secondary objective was to compare the surgical results and complications according to the Clavien–Dindo scale. We treated 156 patients with high-grade invasive bladder cancer with either ORC (n=70) or LRC (n=86). The mean follow-up was 33.5±23.8 (range 12–96) months. The mean age was 66.9+9.4 years, and the male to female ratio was 19:1. Both groups were equivalent in age, stage, positive lymph nodes, in situ carcinoma, preoperative obstructive uropathy, adjuvant chemotherapy and type of urinary diversion. There were no differences between the groups in terms of cancer-specific survival (log-rank; p=0.71). The histopathology stage was the only independent variable that predicted the prognosis. The hospital stay (p=0.01) and operative transfusion rates (p=0.002) were less for LRC. The duration of the surgery was greater for LRC (p