Short term comparative analysis of laparoscopic and open radical cystectomy with extracorporeal urinary diversion

Purpose: We analyzed the efficacy and safety of laparoscopic radical cystectomy (LRC) compared with open radical cystectomy (ORC). Materials and Methods: Between November 2007 and April 2009, we performed LRC to treat bladder cancer in 23 patients and ORC in 64 patients. Data including the patients' clinical characteristics, peri-operative parameters, clinical outcomes, and oncologic outcomes were collected retrospectively and analyzed by use of the Mann-Whitney U test and chi-square test. Results: There were no significant differences in demographic data between the two groups. Operative time was longer (595.2 min vs. 453.1 min; p<0.01) in the LRC group but blood loss was less (634.8 ml vs. 1,415.9 ml; p<0.01) and fewer transfusions were required (13.0% vs. 50.0%; p=0.002) in the LRC group. Days to oral intake (5.7 days vs. 7.3 days; p<0.01), days to drain removal (10.9 days vs. 13.9 days; p=0.014), and length of hospital stay (15.2 days vs. 22.3 days; p<0.01) were shorter in the LRC group. Postoperative complications occurred in 4 cases in the LRC group and 28 cases in the ORC group (17.4% vs. 43.8%, p<0.01). There were no cases with a positive surgical margin in the LRC group and 3 cases in the ORC group. There was no significant difference in the number of lymph nodes excised (17.4 vs. 19.6; p=0.132) between groups. Conclusions: These short-term clinical and oncological results suggest that LRC is a safe and effective method for the treatment of invasive bladder cancer.