Comparison of early stage complications between laparoscopic cystectomy and open radical cystectomy

Abstract

Objective To compare the incidence and characteristics of early stage complications between laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC). Methods From September 2011 to May 2014, we retrospectively analyzed the demographic, perioperative data of 96 (86 males and 10 females) and 105 (86 males and 19 females) patients who had undergone LRC and ORC, respectively. The average age of patients was(64.4±11.4)and (63.7±10.5)years old in ORC and LRC group, respectively. We collected operation time, estimated blood loss, number of transfusion, time to resumption of oral intake, postoperative length of drainage freeand complication rate within 90 days after cystectomy.Categorical variables were analyzed with the 2 test or Fisher′s exact test as appropriate. Continuous variables were compared using the Student′s t-test. Results Mean operative time was significantly longer in LRC group than ORC group (389 vs 321 min, P=0.02). However mean estimated blood loss, postoperative length of stay was significantly less in LRC group than in ORC group(420 vs 591 ml, P=0.003 and 16.5 vs 18.5 d, P=0.04), respectively. Fewer patients in the LRC group need blood transfusion than in ORC group (15 vs 29 patients, P=0.042). The complication rate was significantly less in LRC group as well (28.1% vs 43.8%, P=0.027). No significant differences were found in time resume the intestinal function(3.7 vs 3.5 d), time to resumption of oral intake (4.4 vs 4.3 d)and time to remove the drainage tube (11.1 vs 10.9 d) between two groups, respectively (P>0.05). The incidence of early complication in LRC group was significant lower than that in ORC group(28.1% vs 43.8%, P<0.05). The common complications following LRC were infection (n=7), intestinal obstruction(n=7), lymphatic leak(n=7), while ORC group was infection(n=14), intestinal obstruction (n=13) and liquefied fat (n=11). The incidence of liquefied fat of abdominal incision was significantly less in the LRC group than ORC group (1 vs 11 patients, P=0.006). Conclusion Patients can benefit more from LRC than ORC, because LRC can help to reduce estimated blood loss, postoperative transfusion and complication as well as postoperative length of stay. Key words: Bladder cancer; Laparoscopes; Open; Radical cystectomy; Complications