Laparoscopic radical cystectomy in patients with bladder cancer: A modified technique with reduced morbidity

Abstract

Background:

We describe a modified technique for laparoscopic radical cystectomy (LRC) utilizing a mini-laparotomy incision for conduit formation and compare outcomes with the conventional technique.

Materials and methods:

This retrospective single-centre study included patients with bladder cancer undergoing LRC at a tertiary care centre between September 2019 and December 2024. Patients were divided into conventional LRC (CLRC) and modified LRC (MLRC) groups. Statistical analysis was performed using chi-square and Student’s t-test (p < 0.05 considered significant).

Results:

A total of 228 patients were included (CLRC: 58; MLRC: 170). Operative time was significantly longer in MLRC (253 vs 246 min, p = 0.0018). However, mean blood loss (370 vs 543 ml, p < 0.001), incision size (8.5 vs 14.5 cm, p < 0.001), time to oral intake (3.5 vs 3.8 days, p < 0.001), and hospital stay (10.8 vs 11.6 days, p < 0.001) were significantly reduced. Two early postoperative deaths (Clavien–Dindo Grade V) occurred in CLRC. At 2-year follow-up, recurrence (7.1% vs 10.3%) and mortality (1.2% vs 5.2%) were comparable between groups.

Conclusion:

The modified technique is feasible and reproducible. Despite longer operative time, it significantly reduces postoperative morbidity with comparable short-term oncological outcomes.

Keywords

cancer bladder radical cystectomy surgical technique modified laparoscopic

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