Aboumarzouk Omar M, Drewa Tomasz, Olejniczak Pawel, Chlosta Piotr L
College of Medicine, Islamic University of Gaza, Palestine.
Urol Int. 2013;91(1):109-12. doi: 10.1159/000350237. Epub 2013 Apr 12.
Open radical cystectomy (ORC) is the gold standard of treatment for muscle-invasive bladder cancer. Laparoscopic radical cystectomy (LRC) has emerged to provide an alternative.
Between 2006 and 2012, 155 patients who underwent LRC or ORC were compared (mean follow-up 53 months).
The ORC group had shorter operative times (p < 0.0001), more blood loss (p < 0.00001), more transfusion requirement (p < 0.00001), longer postoperative length of hospital stay (p < 0.00001) and more morphine requirement (p = 0.02). No difference was found regarding lymph node yield (p = 0.07), positive margins (p = 0.11), cystectomy pathology results (p > 0.05) and positive lymph nodes (p = 0.02). The ORC group had less intraoperative complications (p = 0.03). No difference was found between the two groups regarding 5-year overall survival (p = 0.93), cancer-specific survival (p = 0.7) and recurrence-free survival (p = 0.62).
LRC can be considered as an alternative to ORC with good operative and postoperative results in addition to comparable 5-year survival results.
开放性根治性膀胱切除术（ORC）是肌层浸润性膀胱癌的治疗金标准。腹腔镜根治性膀胱切除术（LRC）已成为一种替代方法。
对2006年至2012年间接受LRC或ORC的155例患者进行比较（平均随访53个月）。
ORC组手术时间更短（p < 0.0001），失血量更多（p < 0.00001），输血需求更多（p < 0.00001），术后住院时间更长（p < 0.00001），吗啡需求量更多（p = 0.02）。在淋巴结获取量（p = 0.07）、切缘阳性（p = 0.11）、膀胱切除病理结果（p > 0.05）和阳性淋巴结（p = 0.02）方面未发现差异。ORC组术中并发症更少（p = 0.03）。两组在5年总生存率（p = 0.93）、癌症特异性生存率（p = 0.7）和无复发生存率（p = 0.62）方面未发现差异。
LRC可被视为ORC的替代方法，其手术和术后效果良好，5年生存率相当。
