Laparoscopic radical cystectomy - initial experience

Abstract

Introduction: Radical cystectomy with extended pelvic lymph node dissection is the standard treatment for muscle-invasive bladder cancer. The aim of this study is to report our initial experience of our series of 22 patients who underwent laparoscopic radical cystectomy with different urinary diversion. M aterials and Methods: Between March 2015 and March 2016, 22 patients underwent laparoscopic radical cystectomy with different types of extracorporeal urinary diversion. Patients were aged 54 to 85 (average age 66.3) with different clinical stages of the disease. Transperitoneal laparoscopic radical cystectomy with five ports in all cases was performed with bilateral extended pelvic lymph node dissection. Results: In 5 cases we performed radical cystectomy with subsequent ureterocutaneostomy, in 7 cases we performed ileal conduit according to the method of Bricker, and in 10 cases we formed orthotopic bladder from ileal loop by the method of Hautmann. All operations were performed with an average blood loss of 270 ml, with an average operating time of 5 hours, and an average hospital stay of 7 days. No conversion was required in any case. The patients were observed postoperatively. Early complications (within 30 days) occurred in 2 patients, and late complications occurred in 3 patients. Conclusion: Laparoscopic radical cystectomy is possible, although technically difficult, with significant reduction in patient morbidity. With more experience and an improvement of the surgical technique, laparoscopic radical cystectomy with different types of derivation becomes an alternative surgical method for treating patients with localised muscle invasive bladder carcinoma.