World Journal of Laparoscopic Surgery

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VOLUME 9 , ISSUE 2 ( May-August, 2016 ) > List of Articles


Comparison of Open and Laparoscopic Radical Cystectomy for Bladder Cancer: Safety and Early Oncological Results

Reva Sergey, Nosov Alexander, Djalilov Imran, Petrov Sergey

Citation Information : Sergey R, Alexander N, Imran D, Sergey P. Comparison of Open and Laparoscopic Radical Cystectomy for Bladder Cancer: Safety and Early Oncological Results. World J Lap Surg 2016; 9 (2):51-57.

DOI: 10.5005/jp-journals-10033-1272

Published Online: 01-03-2011

Copyright Statement:  Copyright © 2016; The Author(s).



To evaluate perioperative and postoperative morbidity and functional results of laparoscopic radical cystectomy (LRC) in a single-site cohort of patients by comparing it with standard open radical cystectomy (ORC).

Materials and methods

A prospective analysis was performed in 42 muscle invasive and locally advanced bladder cancer (BCa) patients who underwent radical cystectomy (RC) between February 2012 and March 2014 in N.N. Petrov Research Institute of Oncology, Saint Petersburg, Russia. The final cohort included 21 ORC and 21 LRC patients. The average patients’ age was 64 (38 to 81) years, which did not differ between the groups. The pathological stage was similar in the LRC and ORC groups. Multivariable logistic and median regression was performed to evaluate the operating time, perioperative, and postoperative complications (30-day and 90-day) according to Clavien classification, readmission rates, and length of stay (LOS) – both totally and in ICU.


The operating time during LRC was longer than that of ORC (398 vs 243 minutes respectively). Despite that, there was no statistically significant influence of the type of surgery on intraoperative complications. 14.3% in the ORC group and 4.7% in the LRC patients. The major complication rates (Clavien grade. ≥3; 23.8 vs 19.4%) were similar between the groups. However, LRC had four times lower rate of minor complications (Clavien grade 1 and 2) compared to ORC (4.7 vs 19.0%). Laparoscopic radical cystectomy had a significantly shorter LOS (27.8 vs 22.6 days in the ORC and LRC groups respectively), but no significant differences in ICU stay existed (5.1 vs 2.1 days). Morbidity was presented by one patient in each group (average rate 5.8%). The common transfusion rate during and after surgical intervention was 19.6% and was higher in the ORC group (33.3 vs 4.7% in LRC); additionally, intraoperative bleeding was lower after laparoscopic cystectomy. the average volume of blood loss was 285 mL in LRC and 577 mL during ORC. Depending on the timing of complications, there were 30-day complications in 19 patients (37.2%) and 90 days in 27 patients (52.9%). The greatest difference was observed between the grades of gastrointestinal complications (foremost, ileus) with significantly better outcomes in the LRC patients. 14.2% compared to 47.6% in ORC.


We have found that LRC is safe and associated with lower blood loss, reduced postoperative ileus, and lower LOS compared with ORC. Using a population-based cohort, we have found that laparoscopic surgery for bladder cancer reduced minor complications (mainly due to lower bleeding and gastrointestinal complication rate) and had no impact on major complications.

How to cite this article

Sergey R, Alexander N, Imran D, Sergey P. Comparison of Open and Laparoscopic Radical Cystectomy for Bladder Cancer: Safety and Early Oncological Results. World J Lap Surg 2016;9(2):51-57.

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