Laparoscopic Versus Open Radical Cystectomy For Management Of Bladder Cancer Shot-time Outcome

Bladder cancer is the most common malignancy in the world. Bladder cancer isthe fourth most common malignancy in men and the ninth most common in women inthe USA, with an estimated72570new cases and15210deaths predicted for the year2013. Approximately75–85%of patients with bladder cancer present with diseaseconfined to the mucosa or submucosa and approximately20%of patients present withinvasive disease. Open radical cystectomy (ORC) is the standard treatment forrecurrent high-risk superficial or invasive bladder cancer because it provides excellentlocal cancer control. Since the introduction of laparoscopic radical cystectomy(LRC), LRC had been performed in an increasing number of centers. The potentialbenefits of the laparoscopic approach include lower surgical blood loss, earlier returnof bowel function, and more rapid postoperative convalescence. Therefore, LRC hasbeen proposed to be less traumatic approach than open surgery.ObjectiveLaparoscopic versus open radical cystectomy for management of bladder canceroutcome. Subjects and methodsA retrospective analysis conducted between October2010and August2013inour hospital, a total of30cases were performed laparoscopic radical cystectomy and37cases were underwent open surgery by age, sex, body mass index, smoking,operative time, blood loss, postoperative transfusion rate, exhaust time, hospital stay,complications such as grading and pathological findings were analyzed andcompared.ResultThere was no significant difference between laparoscopic surgery and opensurgery group in age and sex (P＞0.05).The operating time was (310.270.3) min inlaparoscopic surgery group and (306.865.3)min in open surgery group (P＜0.05).The blood loss was (537.6254.3)ml in laparoscopic surgery group and(910.3710.5)ml in open surgery group(P＜0.05).The blood transfusion rate was6.7%in laparoscopic surgery group and27%in open surgery group(P＜0.05).Theexhausting time of laparoscopic surgery group was (3.01.0)d and open surgerygroup was (5.21.2)d (P＜0.05).The feeding time was (5.51.1)d in laparoscopicsurgery group and (7.01.2)d in the open group(P＜0.05).The postoperative hospitalstay was (113.5) d in laparoscopic surgery group and（155.6）d in the opensurgery group（P＜0.05）.The laparoscopic surgery postoperative complication ratewas23.3%,the open surgery postoperative complication rate was45.9%(P＜0.05).There were no differences between the two groups in the positive margin rate, lymphnode-positive rate, postoperative tumor stage, tumor grade and histological type ofurinary diversion.ConclusionLaparoscopic radical cystectomy compared with open surgery, with less bleeding,faster recovery of gastrointestinal function, low incidence of complications andshorter hospital stay and advantages of safe and feasible, recent results weresatisfactory.