[Perioperative outcome of laparoscopic radical cystectomy: comparison to open radical cystectomy]

This study is to elucidate the advantage of laparoscopic radical cystectomy (LRC) over open radical cystectomy (ORC) in an early perioperative period.

We investigated the perioperative outcome of the consecutive patients who underwent radical cystectomy at Yokohama City University Hospital. The data of 11 patients who underwent LRC from February 2008 to May 2009 was compared with that of 11 patients who had ORC from October 2006 to April 2009.

The operative time was significantly longer in LRC (p = 0.00794); the mean operative time for LRC and ORC was 521 and 428 minutes respectively. The blood loss was significantly smaller in LRC (p = 0.0014); the mean volume of bleeding by LRC and ORC was 801 and 2,156 ml respectively. The date of the diet resumption after the operation comes significantly earlier in the case of LRC (p = 0.0142); the mean number of days to the resumption after LRC and ORC were 4.6 and 9.3 respectively. The top C-reactive protein (CRP) figure was significantly lower in LRC (p = 0.0124); the mean of peak CRP after LRC and ORC was 10.8 and 16.6 mg/dl respectively. As for postoperative complications, there were no significant differences between two groups (p = 0.375); the rate of complications occurred after LRC and ORC was 27 and 45% respectively. Also no significant differences were observed as to the number of dissected lymph nodes among these two groups (p = 0.262); the mean number in LRC and ORC was 10.9 and 13.7 respectively.

From our investigations it is appropriate to conclude that in an early perioperative period LRC has advantages over ORC: a smaller amount of blooding, an earlier date of the diet resumption, and a lower peak of CRP. LRC is less invasive than ORC, though the former takes longer time for an operation than the latter.