title: Radical cystectomy for bladder cancer: morbidity of laparoscopic versus open surgery.
abstract: OBJECTIVE
  We compared the morbidity and mortality of laparoscopic vs open surgery in radical cystectomy for bladder cancer.
  
  
  METHODS
  This prospective, nonrandomized study was conducted between January 2003 and July 2007 in 68 patients (7 women and 61 men) who underwent radical cystectomy for bladder cancer. A total of 38 cystectomies were performed laparoscopically and 30 by open surgery. Mean patient age was 68.0 +/- 9.0 years. Median preoperative American Society of Anesthesiologists score was 2 (range 1 to 3) in both groups.
  
  
  RESULTS
  Intraoperative blood loss and transfusion rate were significantly lower in the laparoscopic surgery group. Postoperatively the incidence of minor complications and mortality were also significantly lower. Postoperative opioid consumption was significantly less in the laparoscopic surgery group in amount and duration. Resumption of oral fluid and solid intake as well as return to normal bowel function were significantly more rapid in the laparoscopic surgery group, and mean hospital stay was significantly shorter. Mean patient followup was 30.5 +/- 17.2 months.
  
  
  CONCLUSIONS
  Laparoscopic radical cystectomy for bladder cancer has a lower morbidity rate than cystectomy by open surgery. It allows more rapid resumption of oral fluid and solid intake as well as return to normal bowel function and shorter hospital stay.
authors.affiliation: Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, Toulouse, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Guillotreau
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.forename: Marc
authors.initials: M
authors.lastname: Mouzin
authors.forename: Nicolas
authors.initials: N
authors.lastname: Doumerc
authors.forename: Richard
authors.initials: R
authors.lastname: Mallet
authors.forename: Federico
authors.initials: F
authors.lastname: Sallusto
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D016063:Blood Loss, Surgical / Q000503:physiopathology; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D003558:Cystoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods