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01-12-2014 | Original Article

Long-term evaluation of oncologic and functional outcomes after laparoscopic open-assisted radical cystectomy: a matched-pair analysis

Authors: Simone Albisinni, Ksenija Limani, Lisa Ingels, Felix Kwizera, Renaud Bollens, Eric Hawaux, Thierry Quackels, Marc Vanden Bossche, Alexandre Peltier, Thierry Roumeguère, Roland van Velthoven

Published in: World Journal of Urology | Issue 6/2014

Abstract

Purpose

To evaluate peri- and postoperative morbidity, and long-term oncologic and functional results of our laparoscopic radical cystectomy (LRC) technique, comparing it with our standard open approach.

Methods

Between 2000 and 2010, 54 patients underwent LRC for urothelial cell carcinoma of the bladder in two academic hospitals. The procedures were performed by two surgeons. Patients were matched 1:1 with patients who underwent open RC in the same years by the same surgical team. Differences in peri- and postoperative complications across the two groups were assessed using Wilcoxon’s rank-sum or χ ² test. Kaplan–Meier curves, log-rank tests and Cox regression models were constructed to assess differences in recurrence-free survival on long-term follow-up between the two groups.

Results

Laparoscopic radical cystectomy was significantly associated with lower blood loss (p < 0.0001) and less frequent postoperative ileus (p = 0.03). Regarding more serious postoperative complications, no difference was found across the two cohorts. Median oncologic follow-up was 42 months (IQR 12–72 months) in the LRC cohort and 18 months (IQR 8–27 months) in patients undergoing open radical cystectomy (ORC). No statistically significant difference in recurrence-free survival was observed between the two groups (log rank p = 0.677). On univariate Cox regression, the surgical approach used was not significantly associated with risk of recurrence.

Conclusions

We found that LRC is safe and associated with lower blood loss and decreased postoperative ileus compared with ORC. Moreover, on long-term oncologic follow-up, LRC appeared non-inferior to ORC with no significant difference in recurrence-free survival. Nonetheless, these results must be confirmed by larger series and stronger long-term follow-up data are needed.

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Title: Long-term evaluation of oncologic and functional outcomes after laparoscopic open-assisted radical cystectomy: a matched-pair analysis
Authors: Simone Albisinni
Ksenija Limani
Lisa Ingels
Felix Kwizera
Renaud Bollens
Eric Hawaux
Thierry Quackels
Marc Vanden Bossche
Alexandre Peltier
Thierry Roumeguère
Roland van Velthoven
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 6/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1245-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term evaluation of oncologic and functional outcomes after laparoscopic open-assisted radical cystectomy: a matched-pair analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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