Portal de Periódicos da CAPES

Comparison of Laparoscopic and Open Radical Cystoprostatectomy for Localized Bladder Cancer With 3-Year Oncological Followup: A Single Surgeon Experience

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2007.08.020

1527-3792

Ashok K. Hemal, Surendra B. Kolla,

Urological Disorders and Treatments

No AccessJournal of UrologyAdult urology1 Dec 2007Comparison of Laparoscopic and Open Radical Cystoprostatectomy for Localized Bladder Cancer With 3-Year Oncological Followup: A Single Surgeon Experienceis accompanied byEvaluation of Surgical Energy Devices for Vessel Sealing and Peripheral Energy Spread in a Porcine Model Ashok K. Hemal and Surendra B. Kolla Ashok K. HemalAshok K. Hemal and Surendra B. KollaSurendra B. Kolla View All Author Informationhttps://doi.org/10.1016/j.juro.2007.08.020AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared the results of laparoscopic and open radical cystectomy performed for organ confined bladder cancer by a single surgeon. Materials and Methods: Between June 1999 and December 2005, 55 laparoscopic radical cystectomies were performed by a single surgeon. Of these patients 30 who had organ confined bladder cancer on preoperative evaluation formed the laparoscopic radical cystectomy group and 35 who underwent open radical cystectomy performed by the same surgeon formed the open radical cystectomy group. All patients underwent radical cystectomy, pelvic lymphadenectomy and ileal conduit urinary diversion. In the laparoscopic radical cystectomy group the ileal conduit was created through the 6 to 10 cm midline incision used for specimen extraction. Results: Mean operative time was significantly more in the laparoscopic group. However, mean blood loss, analgesic requirement and transfusion requirement were significantly less in the laparoscopic group. The complication rate in the 2 groups was not significantly different. One patient per group had a margin positive for bladder cancer. At a mean followup of 38 (range 15 to 54) and 46 months (range 14 to 96) 23 patients (76%) in the laparoscopic group and 28 (80%) in the open group, respectively, survived free of recurrence (p = 0.2). Conclusions: The laparoscopic approach provides the benefit of lesser blood loss and postoperative pain in patients undergoing radical cystectomy for organ confined bladder cancer. The oncological outcome is comparable to that of open radical cystectomy at 3-year followup. However, longer followup in a larger cohort of patients is needed to assess long-term oncological and functional outcomes. References 1 : Radical cystectomy in the treatment of bladder cancer: long-term results in 1054 patients. J Clin Oncol2001; 19: 666. Google Scholar 2 : Cystectomy for bladder cancer: a contemporary series. J Urol2001; 165: 1111. Link, Google Scholar 3 : Laparoscopic radical cystectomy with continent urinary diversion (recto-sigmoid pouch) performed completely intracorporeally: the initial 5 cases. J Urol2001; 165: 1863. Link, Google Scholar 4 : Laparoscopic radical cystectoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases. Urology2000; 56: 26. Google Scholar 5 : Laparoscopic radical cystectomy and continent orthotopic ileal neobladder performed completely intracorporeally: the initial experience. J Urol2002; 168: 13. Link, Google Scholar 6 : Laparoscopic radical cystectomy with continent urinary diversion (recto-sigmoid pouch) performed completely intracorporeally: an intermediate functional and oncological analysis. Urology2004; 64: 935. Google Scholar 7 : Laparoscopic radical cystoprostatectomy: our experience in a consecutive series of 10 patients with a 3-years follow-up. Eur Urol2005; 47: 785. Google Scholar 8 : Laparoscopic assisted radical cystectomy with ileal neobladder: a comparison with open approach. J Urol2004; 172: 489. Link, Google Scholar 9 : Laparoscopic radical cystectomy and ileal conduit reconstruction: preliminary experience. J Endourol2003; 17: 911. Google Scholar 10 : Estimated blood loss and transfusion requirements of radical cystectomy. J Urol2001; 166: 2151. Link, Google Scholar 11 : Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol2000; 164: 1153. Link, Google Scholar 12 : Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol2003; 169: 1689. Link, Google Scholar 13 : Laparoscopic assisted radical cystectomy: the Montsouris experience after 84 cases. Eur Urol2005; 47: 780. Google Scholar 14 : Extent of surgery and pathologic evaluation has an impact on bladder cancer outcomes after radical cystectomy. Urology2003; 61: 105. Google Scholar 15 : Prospective packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol2004; 172: 1286. Link, Google Scholar 16 : Radical cystectomy in the elderly: Comparison of clinical outcomes between younger and older patients. Cancer2005; 104: 36. Google Scholar Department of Urology, All India Institute of Medical Sciences, New Delhi, India© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byChade D, Laudone V, Bochner B and Parra R (2010) Oncological Outcomes After Radical Cystectomy for Bladder Cancer: Open Versus Minimally Invasive ApproachesJournal of Urology, VOL. 183, NO. 3, (862-870), Online publication date: 1-Mar-2010.Guillotreau J, Gamé X, Mouzin M, Doumerc N, Mallet R, Sallusto F, Malavaud B and Rischmann P (2008) Radical Cystectomy for Bladder Cancer: Morbidity of Laparoscopic Versus Open SurgeryJournal of Urology, VOL. 181, NO. 2, (554-559), Online publication date: 1-Feb-2009.Related articlesJournal of Urology17 Oct 2007Evaluation of Surgical Energy Devices for Vessel Sealing and Peripheral Energy Spread in a Porcine Model Volume 178Issue 6December 2007Page: 2340-2343 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsbladderurinary diversionbladder neoplasmslaparoscopycystectomyAcknowledgmentsDr. I. S. Gill, Head, Section of Laparoscopic and Robotic Urology, Glickman Urology Institute, Cleveland Clinic Foundation stimulated interest at our laparoscopic bladder cancer program by performing 5 cases of LRC with an intracorporeal ileal conduit at our institution.Metrics Author Information Ashok K. Hemal More articles by this author Surendra B. Kolla More articles by this author Expand All Advertisement PDF downloadLoading ...