Abstract
BackgroundThis study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit.MethodsEighty-four patients, who were diagnosed with high-risk non-muscle-invasive and muscle-invasive bladder carcinoma and underwent LRC with an ileal conduit between January 2018 and April 2020, were retrospectively evaluated. Thirty and fifty-four patients respectively underwent the three-port approach and five-port LRC. Clinical characteristics, pathological data, perioperative outcomes, and follow-up data were analysed.ResultsThere were no differences in perioperatively surgical outcome, including pathology type, prostate adenocarcinoma incidence, tumour staging, and postoperative creatinine levels between the two groups. The operative time (271.3 ± 24.03 vs. 279.57 ± 48.47 min, P = 0.299), estimated blood loss (65 vs. 90 mL, P = 0.352), time to passage of flatus (8 vs. 10 days, P = 0.084), and duration of hospitalisation post-surgery (11 vs. 12 days, P = 0.922) were no clear difference between both groups. Compared with the five-port group, the three-port LRC group was related to lower inpatient costs (12 453 vs. 14 134 $, P = 0.021). Our follow-up results indicated that the rate of postoperative complications, 90-day mortality, and the oncological outcome did not show meaningful differences between these two groups.ConclusionsThree-port LRC with an ileal conduit is technically safe and feasible for the treatment of bladder cancer. On comparing the three-port LRC with the five-port LRC, our technique does not increase the rate of short-term and long-term complications and tumour recurrence, but the treatment costs of the former were reduced.
Highlights
This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit
The ileal conduit was placed into the peritoneal cavity, and the distal end of the Conventional five-port LRC with an ileal conduit was performed in accordance with a previously described methom [9], including pelvic lymph node dissection (PLND), Radical cystectomy (RC), and the use of a conventional ileal conduit
Compared with the five-port group, the treatment cost was significantly lower in the three-port LRC group (12 453 vs. 14 134 $, P = 0.021)
Summary
This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit. Radical cystectomy (RC) and urinary diversion remain standard procedures for high-risk non-muscle-invasive and muscle-invasive bladder carcinoma [1]. There is evidence that RARC has the advantages of reducing the complication rate and enhancing postoperative recovery, Tuo et al BMC Urology (2021) 21:159 and its therapeutic effect is equivalent to that of ORC [3, 5, 6]. Many bladder cancer patients undergo RARC, the treatment costs remain high [7]. Urologists face this problem in many developing countries. Similar situations exist in other developing countries [8]; traditional LRC is still the mainstay of treatment for bladder cancer
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