복강경 근치적 방광적출술과 개복 근치적 방광적출술의 단기 수술 성적 비교
Short Term Comparative Analysis of Laparoscopic and Open Radical Cystectomy with Extracorporeal Urinary Diversion
정재용, 정병창, 서성일,
소속 상세정보
정재용 ( Jeong Jae-Yong )
성균관대학교 의과대학 비뇨기과학교실
정병창 ( Jeong Byong-Chang )
성균관대학교 의과대학 비뇨기과학교실
서성일 ( Seo Seong-Il )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320090500111083
Abstract
Purpose: We analyzed the efficacy and safety of laparoscopic radical cystectomy (LRC) compared with open radical cystectomy (ORC).
Materials and Methods : Between November 2007 and April 2009, we performed LRC to treat bladder cancer in 23 patients and ORC in 64 patients. Data including the patients’ clinical characteristics, peri-operative parameters, clinical outcomes, and oncologic outcomes were collected retrospectively and analyzed by use of the Mann-Whitney U test and chi-square test.
Results: There were no significant differences in demographic data between the two groups. Operative time was longer (595.2 min vs. 453.1 min; p＜0.01) in the LRC group but blood loss was less (634.8 ml vs. 1,415.9 ml; p＜0.01) and fewer transfusions were required (13.0% vs. 50.0%; p=0.002) in the LRC group. Days to oral intake (5.7 days vs. 7.3 days; p＜0.01), days to drain removal (10.9 days vs. 13.9 days; p=0.014), and length of hospital stay (15.2 days vs. 22.3 days; p＜0.01) were shorter in the LRC group. Postoperative complications occurred in 4 cases in the LRC group and 28 cases in the ORC group (17.4% vs. 43.8%, p＜0.01). There were no cases with a positive surgical margin in the LRC group and 3 cases in the ORC group. There was no significant difference in the number of lymph nodes excised (17.4 vs. 19.6; p=0.132) between groups.
Conclusions: These short-term clinical and oncological results suggest that LRC is a safe and effective method for the treatment of invasive bladder cancer.
키워드
Cystectomy;Urinary bladder neoplasms;Laparoscopy
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