Our first experience of laparoscopic cystectomy in the treatment of muscle invasive bladder cancer

Objective. Radical cystectomy is the gold standart in the treatment of muscle invasive bladder cancer. We report our initial experience with laparoscopic cystectomy with low-invasive laparotomy and formation of the neobladder by Studer. Results were compared with traditional cystectomy.
Materials and Methods. Since 2003 five patients (1) underwent a laparoscopic cystectomy at our hospital. All patients were male (with a mean age of 57(51—67) and had T2N0M0 stage bladder cancer (G1-2). The procedure consists of two parts: 1 — laparoscopic mobilization of the bladder, ureters, prostate glang and vesicles; 2 — low invasive laparotomy (length 4—5 cm) with special tools and illumination, extraction of the bladder and formation of the neobladder by Studer. Traditional cystectomy (2) with orthotopic neobladder has been applied to 49 patients. There were 45 males and 4 females. Mean age was 62,7 (39—74).
Results. In the first group (1) the mean time of procedure was 505 (430—570) min. Blood loss was between 150—300 ml. There were not serious postoperative complications. Function of intestines was restored in 4 days. The ureteral drainages were removed on 14 day, urethral catheters — on 16 postoperative day. Urodynamic studies after procedure revealed Q max — 18,4 (17—19) ml/sec. In the second group (2) the mean time of procedure was 306 (246—350) min. Blood loss was between 615 (300—1200) ml. Function of intestines was restored in 7 days.
Conclusions. Our initial results indicate, that a laparoscopic cystectomy is an effective surgical method, which is less invasive and deleterious in comparison with open cystectomy.