title: [Treatment outcome of laparoscopic radical cystectomy at a single institution].
abstract: OBJECTIVE
  The standard care for invasive bladder cancer is radical cystectomy with urinary diversion, but laparoscopic radical cystectomy (LRC) is still being evaluated. We describe our initial experience of laparoscopic radical cystectomy compared to open radical cystectomy (ORC).
  
  
  METHODS
  From January 2000 to June 2012, 84 patients underwent radical cystectomy by ORC (n = 54) or LRC (n = 30). Treatment outcomes including surgical and oncological outcomes between LRC and ORC were compared. We also assessed learning curve during LRC as to blood loss, operating time and complication rate.
  
  
  RESULTS
  The patients' characteristics were similar in LRC and ORC groups except for ASA score. Importantly, Operating time during LRC was longer but complication rate of LRC was lower than that of ORC (586 min vs 424 min and 40% vs 69%, respectively). In addition, pathological stage or outcomes were similar in both groups and there were no significant difference between LRC and ORC groups in terms of overall and recurrence free survival rate. As for learning curve of LRC, operating time and blood loss tended to decrease with increased experience.
  
  
  CONCLUSIONS
  These results indicate that LRC could be performed safely with decreased complication rate and similar oncological outcomes compared to ORC.
authors.affiliation: Department of Urology, Ijinkai Takeda General Hospital, Kyoto, Japan. t.kan@kuhp.kyoto-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Kanno
authors.forename: Ayumu
authors.initials: A
authors.lastname: Matsuda
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishiyama
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Oida
authors.forename: Takashi
authors.initials: T
authors.lastname: Okada
authors.forename: Toshiya
authors.initials: T
authors.lastname: Akao
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*