Laparoscopic radical cystectomy: Uludag University experience

Abstract

Objective: To present the experience of our clinic on laparoscopic radical cystectomy (LRC).Materials and methods: Twenty-three patients who underwent laparoscopic radical cystectomy, lymphadenectomy and urinary diversion between May 2006 and April 2009 were included. Twenty-two patients were male and one was female. Mean age of patients was 61.5 (40-75) years.Results: Mean total operative time was 388 (270-510) minutes, whereas mean time for laparoscopic cystectomy and lymph node dissection was 225 (180-310) minutes. Simultaneous nephroureterectomy was performed in two patients. Ileal conduit was performed in 20 patients as urinary diversion and orthotopic neobladder was constructed in 3. Mean blood loss was 130 mL (40-300) and intraoperative blood transfusion was not necessary in any of the patients. Mean postoperative hospitalization was 11.1 (7-24) days. No intraoperative complication was experienced and conversion to open surgery has never happened. Superficial wound infection and dehiscence have happened in 2 patients and prolonged ileus was encountered in 1 patient. Histological examination revealed organ confined (pT0/pT1/pT2/pT3a) disease in 21 (91.3%), extravesical (pT3b/pT4) disease in 2 (8.7%), and lymph node involvement in 4 (17%) patients. Four patients with lymph node involvement, 1 patient with squamous cell cancer, and 1 patient with neuroendocrin carcinoma received adjuvant chemotherapy. Within a mean time period of 13.1 (1-26) months, 95.6% (22/23) of patients, including patients who were given adjuvant chemotherapy, were alive. No port site metastasis has been reported during the follow-up period.Conclusion: Our clinical experience confirms that LRS can be performed safely without compromising the oncological principles.