Akin Yigit, Celik Orcun, Ates Mutlu, Nuhoglu Baris, Erdogru Tibet
Department of Urology, Erzincan University School of Medicine, Erzincan, Turkey.
Urol Int. 2013;90(3):348-53. doi: 10.1159/000346755. Epub 2013 Feb 8.
To compare the outcomes of laparoscopic (LRCP) and open radical cystoprostatectomy (ORCP) with orthotopic urinary diversion for muscle-invasive organ-confined bladder cancer by a single surgeon.
Prospectively documented 15 LRCP and 15 ORCP patients, followed for at least 3 years, were included in our study. The demographic parameters of patients, preoperative radiologic staging, previous operations, surgical outcomes, complications, oncologic results and intermediate-term follow-up, postoperative chemotherapy and follow-up periods were recorded and evaluated.
The mean oncologic follow-up was 3 years. Transfusion rate, estimated blood loss, oral intake and narcotic analgesic requirement were statistically less in the LRCP group (p < 0.05). However, operation time and hospital stay were similar in both groups. The complication rates were not significantly different between the two groups. The mean number of dissected lymph nodes was 20.0 ± 1.7 in the ORCP and 22.6 ± 2.0 in the LRCP group. One patient in each group had a margin positive for bladder cancer.
The laparoscopic approach may be feasible for muscle-invasive organ-confined bladder cancer. Furthermore, LRCP provides less blood loss, early oral intake and postoperative pain management. Additionally, continence and sexual function may be provided by LRCP as with ORCP.
由单一外科医生比较腹腔镜根治性膀胱前列腺切除术（LRCP）和开放性根治性膀胱前列腺切除术（ORCP）联合原位尿流改道术治疗肌层浸润性局限于器官的膀胱癌的疗效。
前瞻性记录的15例LRCP患者和15例ORCP患者纳入我们的研究，随访至少3年。记录并评估患者的人口统计学参数、术前放射学分期、既往手术史、手术结果、并发症、肿瘤学结果和中期随访、术后化疗及随访时间。
平均肿瘤学随访时间为3年。LRCP组的输血率、估计失血量、口服摄入量和麻醉性镇痛药需求量在统计学上较少（p<0.05）。然而，两组的手术时间和住院时间相似。两组的并发症发生率无显著差异。ORCP组平均清扫淋巴结数为20.0±1.7个，LRCP组为22.6±2.0个。每组各有1例患者膀胱癌切缘阳性。
腹腔镜手术方法对于肌层浸润性局限于器官的膀胱癌可能是可行的。此外，LRCP术中失血更少，术后能更早经口进食并进行疼痛管理。另外，与ORCP一样，LRCP也可保留控尿和性功能。
