Laparoscopic Radical Cystectomy (LRC) has been proposed since 1999 as a less invasive alternative to Open Radical Cystectomy (ORC). Pioneers of the technique claim that LRC led to faster recovery, shorter hospital stay and more rapid return to daily activities respect to ORC while offering the same functional and oncological results. About 900 cases are published in peer reviewed papers. The greatest series is formed by a cohort of 85 patients. The preferred urinary diversion is the ileal conduit (46%) although in recent series the ileal neobladder is increasingly adopted. Urinary diversion is usually performed extracorporeally through an abdomen incision of about 5-10 used also for the extraction of the specimen. The mean or median follow up of LRC series does not exceed 31 months and the longest follow up reported up to now is 58 months in the series examined. Overall survival rate varies from 72% to 95%. While feasibility of LRC has been demonstrated, cancer control has far from been assured, mainly in consequence of limited follow-up of the series and an unexpected low disease free survival rate. Moreover the advocated advantages related to LRC seem to be related to patients' selection rather than to less invasiveness. Actually when characteristics of the patient and of the disease are similar, outcomes of LRC and ORC, in terms of hospitalization and recovery, are comparable. LRC is currently an experimental procedure which can not be considered at the present time a concrete alternative to ORC.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Incidence and Outcomes of Secondary Bladder Cancer Following Radiation Therapy for Prostate Cancer: A Systematic Review and Meta-analysis.
Eur Urol Focus
January 2025
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Semmelweis University, Budapest, Hungary; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia; Division of Urology, Department of Special Surgery, University of Jordan, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Research Center for Evidence Medicine, Urology Department, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:
Background And Objective: There is an established association between secondary bladder cancers (SBCs) and radiotherapy (RT) for prostate cancer (PC), which remains a significant concern. Our aim was to update the evidence on SBC incidence across different RT modalities and to compare oncological outcomes for patients diagnosed with SBC to those diagnosed with primary bladder cancer (PBC).
Methods: We searched MEDLINE, Scopus, and Web of Science for studies on SBC following PC.
Metformin intake and risk of metabolic acidosis after radical cystectomy with urinary diversion: A comparative study using data from the TriNetX research network.
Urol Oncol
January 2025
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address:
Purpose: To investigate the association of diabetes mellitus and metformin use with metabolic acidosis risk after radical cystectomy (RC) and urinary diversion for bladder cancer.
Materials And Methods: This retrospective cohort study used TriNetX Research Network data. Patients undergoing RC with continent diversion or ileal conduit for bladder cancer were identified using International Classification of Diseases, 10th Revision (ICD-10) and ICD-10 Procedure Coding System (ICD-10-PCS) codes.
Background: Radical cystectomy has the potential to be a curative strategy for patients with aggressive bladder cancer. Emerging evidence over the last 20 years has shown that minimally invasive surgical approaches using robotics in performing this highly complex and morbid operation can achieve the same oncological outcomes while reducing complications for the patient.
Objective: This paper aims to present a managerial and leadership roadmap for change to robotic cystectomy for patients with advanced bladder cancer to achieve improved patient outcomes while embracing technological developments in the delivery of cancer care.
Association of Prehabilitation in the Precystectomy Pathway in Patients With Bladder Cancer on Postoperative Outcomes.
Clin Genitourin Cancer
December 2024
University of North Carolina School of Medicine, Chapel Hill, NC; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Department of Urology, University of North Carolina, Chapel Hill, NC.
Purpose: Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.
Methods: We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.
Immunotherapy-based neoadjuvant treatment and complication rates after radical cystectomy.
BJU Int
January 2025
Urology Department, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Objective: To assess 30- and 90-day postoperative complication rates in patients who underwent robot-assisted radical cystectomy (RARC) after receiving novel immunotherapy-based neoadjuvant treatment.
Methods: A bi-centre analysis was conducted in patients who underwent RARC with intracorporeal urinary diversion and who received an immunotherapy-based neoadjuvant regimen between 2017 and 2023. Complications were classified using the Clavien-Dindo system.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!