[LAPAROSCOPIC RADICAL CYSTECTOMY AT HIROSHIMA CITY ASA HOSPITAL]

(Objective) To evaluate the utility of laparoscopic radical cystectomy (LRC), we retrospectively compared the background factors and perioperative parameters of LRC with those of open radical cystectomy (ORC). (Patients and methods) The study cohort consisted of 116 consecutive patients who underwent radical cystectomy by LRC (n=59) or ORC (n=57). The background factors and perioperative parameters were compared between LRC and ORC. (Results) The patients consisted of 103 men and 13 women with a median age of 69 years and median BMI of 23.0. Their clinical stage was as follows, ≤T1: 19 cases, T2: 69 cases, T3: 25 cases and T4: 3 cases, respectively.While the patients' age at the time of LRC was significantly higher than that of ORC (71.3 yrs vs. 66.2 yrs, P<0.001) and the ASA physical status of LRC was significantly higher than that of ORC (P=0.028), the other background factors were not different between the two groups.Although there was no difference in the total operating time between LRC and ORC, the estimated blood loss for LRC was significantly less than that for ORC (372.3 ml vs. 2,134.5 ml, P<0.001) and the duration of the postoperative hospital stay for LRC was significantly shorter than that for ORC (23.5 days vs. 36.9 days, P<0.001).There were no significant differences in the pathological findings, of the postoperative recurrence-free rate or cancer-specific survival rate between the LRC and ORC groups. In multivariate analysis, only pN+was an independent predictive factor of postoperative recurrence. (Conclusion) This study showed that LRC is less invasive and can lead to similar oncological outcomes compared with ORC.