Laparoscopic partial cystectomy in bladder cancer -- initial experience.

PROPOSAL The authors present their initial experience with a selected group of patients who underwent laparoscopic partial cystectomy for treating bladder cancer. MATERIALS AND METHODS In the period from June 1997 to April 2000, 6 patients, aged between 38 and 76 years, having transitional cell carcinoma of the bladder, were identified as candidates to partial cystectomy. The procedure employed consisted in laparoscopic partial cystectomy and lymphadenectomy with exclusive intracorporeal suture technique. RESULTS The proposed procedure was completed in all cases. Mean surgical time was 205 minutes and mean blood loss was 200 mL. There were no significant complications during both intra- and post-operative period. Two patients (33%) presented urinary extravasation of less than 50 mL, with spontaneous resolution. Mean hospitalization period was 4 days (2 to 6). The histological analysis of the resected specimens revealed transitional cell carcinoma, stage pT1G3 in case 1, pT2aG2 in cases 2 to 4, pT2bG2 in case 5 and pT3aG3 in case 6. The resection margins, as well as lymph nodes, were free of neoplasia. One patient developed local and metastatic disease, and was treated with salvage chemotherapy. No other case of local or systemic recurrence was observed with a mean follow-up of 30 months. CONCLUSIONS Laparoscopic partial cystectomy can be an alternative surgical method for treating selected cases of patients with transitional cell carcinoma of the bladder.