Extraperitoneal Versus Transperitoneal Laparoscopic Radical Cystectomy For Initial Experience

Objective:This study compared with the efficacy of extraperitoneal laparoscopic radical cystectomy(ELRC)and transperitoneal laparoscopic radical cystectomy(TLRC)in the treatment of bladder cancer patients,which in order to explore the feasibility and safety of the extraperitoneal laparoscopic radical cystectomy(ELRC)and to provide guidance for clinical work.Materials and methods: Fifteen patients(mean age: 62.9 ± 12.9)underwent laparoscopic extraperitoneal radical cystectomy And 17 patients(mean age: 66.3 ± 10.6)underwent transperitoneal laparoscopic total cystectomy were collected from January 2011 to October 2016 in our hospital.The operative parameters were compared with each other,including the operative time,intraoperative blood loss,postoperative exhaust time,defecation time,postoperative feeding time,number of days of postoperative infusion,postoperative complications and postoperative tumor findings.The results of the study using SPSS20.0 statistical software for analysis,measurement data using independent sample T test and the count data using the card Test to verify.Results: A significantly shorter time to exsufflation and liquid intake were observed in the ELRC group compared with the TLRC group.The incidence of postoperative ileus in the ELRC group was lower than the TLRC group(P<0.05).However,the removed lymph node number in the ELRC group was significantly lower than the TLRC group(P<0.05)and the operation time was relatively long.(P = 0.075> 0.05).The bowel movement of the ELRC group was less than that of the conventional surgery group(4.2 ± 1.4 vs 5.1 ± 1.5),which was also a step forward.No significant differences were observed between the two groups oncology results(p>0.05).Summary: Extraperitoneal laparoscopic radical cystectomy is a safe and feasible surgical strategy.For patients with bladder cancer,the extraperitoneal route faster recovery of intestinal function after surgery,postoperative intestinal complications associated with less compared to the traditional approach.The study has some limitations,further studies with a large series including different urinary diversions are needed to confirm our results and to better evaluate the benefit of ELRC in bladder cancer patients.