title: Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience.
abstract: OBJECTIVE
  This study reports the initial experience of extraperitoneal laparoscopic radical cystectomy (ELRC) and compared with transperitoneal laparoscopic radical cystectomy (TLRC) in the treatment of selected elderly bladder cancer patients.
  
  
  METHODS
  A total of forty male bladder cancer patients who underwent ELRC (n=19) or TLRC (n=21) with ureterocutaneostomy were investigated. Demographic parameters, perioperative variables, oncological outcomes and follow-up data were retrospectively analyzed.
  
  
  RESULTS
  A significantly shorter time to exsufflation (1.5±0.7 vs 2.1±1.1 d; p=0.026) and liquid intake (1.8±0.9 vs 2.8±1.9 d; p=0.035) were observed in the ELRC group compared with the TLRC group. The incidence of postoperative ileus in the ELRC group was lower than the TLRC group (0 vs 9.5%). However, the difference had no statistical significance (p>0.05). The removed lymph node number in the ELRC group was significantly lower than the TLRC group (p<0.001). No significant differences were observed between the two groups in the overall and cancer-free survival rates (p>0.05).
  
  
  CONCLUSIONS
  ELRC seems to be a safe and feasible surgical strategy for the selected elderly bladder cancer patients with ≤T2 disease. The surgical and oncological efficacy of the ELRC is similar to that of the TLRC, but with faster intestinal function recovery. Further studies with a large series including different urinary diversions are needed to confirm our results and to better evaluate the benefit of ELRC in bladder cancer patients.
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Lang
authors: L
authors: Feng
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Jian
authors: J
authors: Song
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Menghua
authors: M
authors: Wu
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Ye
authors: Y
authors: Tian
authors: Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
authors: Daoxin
authors: D
authors: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D061646:Operative Time; D010781:Photography; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods
keywords: Cystectomy; Laparoscopy; Oncology