Tobias-Machado Marcos, Said Danniel Frade, Mitre Anuar Ibrahim, Pompeo Alexandre, Pompeo Antonio Carlos Lima
Departmento de Urologia, Seção de Urologia Oncológica da Faculdade de Medicina do ABC, Santo André, Brasil.
Departamento de Urologia - Faculdade de Medicina da Universidade de São Paulo, Brasil.
Int Braz J Urol. 2015 Jul-Aug;41(4):635-41. doi: 10.1590/S1677-5538.IBJU.2014.0168.
To evaluate the differences of peri-operatory and oncological outcomes between Laparoscopic Radical Cystectomy and Open Radical Cystectomy in our center.
Overall, 50 patients were included in this non randomized match-pair analysis: 25 patients who had undergone Laparoscopic Radical Cystectomy for invasive bladder cancer (Group-1) and 25 patients with similar characteristics who had undergone Open Radical Cystectomy (Group-2). The patients were operated from January 2005 to December 2012 in a single Institution.
Mean operative time for groups 1 and 2 were 350 and 280 minutes (p=0.03) respectively. Mean blood loss was 330 mL for group 1 and 580 mL for group 2 (p=0.04). Intraoperative transfusion rate was 0% and 36% for groups 1 and 2 respectively (p=0.005). Perioperative complication rate was similar between groups. Mean time to oral intake was 2 days for group 1 and 3 days for group 2 (p=0.08). Median hospital stay was 7 days for group 1 and 13 for group 2 (p=0.04). There were no differences in positive surgical margins and overall survival, between groups.
In a reference center with pelvic laparoscopic expertise, Laparoscopic Radical Cystectomy may be considered a safe procedure with similar complication rate of Open Radical Cystectomy. Laparoscopic Radical Cystectomy is more time consuming, with reduced bleeding and transfusion rate. Hospital stay seems to be shorter. Oncologically no difference was observed in our mid-term follow-up.
评估我院腹腔镜根治性膀胱切除术与开放性根治性膀胱切除术在围手术期及肿瘤学结局方面的差异。
本非随机配对分析共纳入50例患者：25例行腹腔镜根治性膀胱切除术治疗浸润性膀胱癌的患者（第1组）和25例具有相似特征的行开放性根治性膀胱切除术的患者（第2组）。这些患者于2005年1月至2012年12月在同一机构接受手术。
第1组和第2组的平均手术时间分别为350分钟和280分钟（p = 0.03）。第1组平均失血量为330 mL，第2组为580 mL（p = 0.04）。第1组和第2组的术中输血率分别为0%和36%（p = 0.005）。两组围手术期并发症发生率相似。第1组经口进食的平均时间为2天，第2组为3天（p = 0.08）。第1组的中位住院时间为7天，第2组为13天（p = 0.04）。两组在手术切缘阳性率和总生存率方面无差异。
在具备盆腔腹腔镜技术专长的参考中心，腹腔镜根治性膀胱切除术可被视为一种安全的手术，其并发症发生率与开放性根治性膀胱切除术相似。腹腔镜根治性膀胱切除术耗时更长，但出血和输血率降低。住院时间似乎更短。在我们的中期随访中，未观察到肿瘤学方面的差异。
