Laparosocopic Radical Cystectomy

Objective:To evaluate the surgical technique and clinical efficacy of laparoscopic radical cystectomy (LRC)for bladder cancer.Methods:From January 2008 to November 2009. we treated a total of 20 cases of bladder cancer with LRC. The cases include 19 males and 1 female aged 40～78 years (mean60.7±11.5 years).All the cases were distantmetastasis-free urothelial carcinoma. We performed laparoscopic radical cystectomy on 15 cases plus orthotopic ileal neobladder,on 4 cases plus ileal neobladder and on 1 cases plus rectum pouch. The operation time, the blood loss, the oral intake time and the complication were observed. The results were evaluated with the open surgery and article about LRC to detect the advantage and disadvantage of LRC.Results:The mean operating time was 7.6±1.58h.The mean blood loss was 592.5±488.6ml.The mean oral intake time after operation was 4.6±1. 1day.The hospitalize time after operation was 31.5±8.2 day.The patients have not any postoperative early complications. the follow-up period is 4-21 months, mean time is 12±4.5 months.2 cases died of cancer recurrence.5 patients had complications after leaving the hospital, with 2 cases of urine infection,1 of urethrostenosis,1 of wound dehiscence and 1 of urine retention. all the patients achieved automatic micturition during daytime,3 patients had urinary incontinence occasionally at night.Conclusions:Laparoscopic radical cystectomy had advantages of less blood loss, shorter oral intake time, less postoperative complications, but had disadvantage of more operation time at present. Long-term follow up is need to confirm the tumor control.