Category: Laparoscopic/ Robotic: Other

MP30-4 - Impact of clinical stage on outcome of laparoscopic radical cystectomy: a prospective cohort study

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Radical cystectomy (RC) is the standard of care for treatment of localized muscle-invasive bladder cancer (BC). There has been a worldwide shift towards laparoscopic RC (LRC) which improved markedly the morbidity profile and recovery time with comparable oncological outcome to open surgery. However, most LRC series have favored patients with more localized disease and less comorbid conditions. The aim of the present study was to compare the safety and outcome of LRC for cT2 versus higher stages.


Methods :

This is a prospective cohort study that recruited patients with cT2-3 BC amenable for LRC from January 2015 to March 2017. Patients with clinically positive L.N.s or BMI ≥ 35 were excluded. LRC was performed using 4-5 ports which were placed in a fan shaped manner across the lower abdomen in addition to 10 mm camera port one finger breadth above the umbilicus. Studer orthotopic neobladder or ileal conduit were performed. All ureterointestinal anastomoses were stented with 8Fr external feeding tube which was removed 5-9 days postoperatively before discharge. Neobladder patients were discharged with urethral catheter which was removed 2 weeks postoperatively following a pouchogram to rule out leakage.


Results : LRC was completed for 47 patients while 2 (4.7%) cases were converted to palliative chemo-radiotherapy due to fixation to the lateral pelvic wall and irresectability even upon open exploration. The pathological findings are presented in Table 1. Upon final pathological assessment, 21/47 (44.68%) patients were upgraded from cT2 to higher pathological stages. The perioperative data is presented in table 2. We compared the effect of clinical stage on LRC outcome and found no significant difference between cT2 and higher stages (Table 2). Patients were followed for 1 year and there was no recurrence.


Conclusions : LRC is a feasible and safe technique. After establishment of an adequate learning curve, clinical stage of the tumor may not represent a major obstacle in front of LRC.

Ahmed Abdallah Ashmawy

Lecturer of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt

Ahmed Assem

Assistant Lecturer of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt

Mohammed S. ElSheemy

Associate Professor of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt

Ismail R. Saad

Professor of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt

Ashraf Abo El-Ela

Professor of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt

Mohamed ELgammal

Professor of Urology
Cairo University, Egypt
Cairo, Al Qahirah, Egypt