Análisis comparativo entre el abordaje abierto y laparoscópico en la cistectomía en los pacientes con cáncer de vejiga

Résumé

Despite technical advances and perioperative improvements in the management of the patient undergoing radical cystectomy, this procedure remains a challenge associated with high morbidity and mortality rates. Similarly to what happened in other oncological entities, the implementation of the laparoscopic approach in this procedure has not been widely adopted among urologists. The causes that may explain this fact are technical difficulty (that limits its reproducibility), and concerns regarding adequate oncological control (due to the increased risk of tumor spreading with the laparoscopic approach). Currently, there is still no evidence of a clear benefit of the laparoscopic radical cystectomy(LRC) when compared to what is still considered the standard: open radical cystectomy(ORC). PURPOSE: The aim of this study is to evaluate the efficacy of the laparoscopic approach in opposition to its open counterpart by analyzing morbidity and oncological results: overall and specific cancer survival, surgical margins, and recurrence. In addition, we analyze our own experience with laparoscopic radical cystectomy...