Laparoscopic radical cystectomy (LRC) is a challenging technique, but it has been proposed as an alternative to open radical cystectomy (ORC), which is currently the gold standard treatment for muscle-invasive or highrisk superficial bladder cancer. So far, approximately 200 cases treated with LRC have been reported in the peer-reviewed literature, but follow-up has generally been short (all < 48 months). A shorter hospital stay and a quicker recovery of the patient seem to be the main advantages of LRC over ORC. Functional outcomes, cancer control obtained, and safety of the technique need to be confirmed by studies with larger cohorts of patients and longer follow-up than those previously reported, but an initial analysis suggests that LRC is not equivalent to ORC. Given that the majority of patients selected for LRC had lower American Society of Anesthesiologists scores and lower pathological stages than those in ORC studies, the proportion of patients with orthotopic neobladders (47%) and the proportion of diseasefree patients (80%) seem to be suboptimal and, actually, those might represent the major disadvantages of LRC.
KEYWORDS: bladder carcinoma, laparoscopy, radical cystectomy, urinary
bladder, urinary diversion
Received 17 August 2006 Accepted 15 May 2007href="http://www.uropro.it/pubblicazioni/">clicca qui per leggere la versione completa in PDF