Clinical Efficacy Analysis of Two Different Surgical Approaches to Laparoscopic Radical Cystectomy with Urinary Diversion for Invasive Bladder Cancer

Objective: The present study aimed to compare the efficacy, and advantages and disadvantages of laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy versus laparoscopic radical cystectomy + ileal cystoplasty (Bricker procedure) in the treatment of invasive bladder cancer. Method: Forty-five patients (retrospectively registered) with grade II–III bladder invasive urothelial carcinoma were divided into two groups to compare clinical efficacy, operative duration and blood loss, postoperative intestinal function recovery, length of hospitalization, and complications. Those in the ureterocutaneostomy group (n=25) were treated using laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy, while those in the ileal cystoplasty group (n=20) were treated using laparoscopic radical cystectomy + ileal cystoplasty. Results: Laparoscopic radical cystectomy + extraperitoneal bilateral ureterocutaneostomy shortened the operation, improved patient tolerance, and decreased postoperative intestinal function recovery time. However, its long-term clinical efficacy needs further study using larger sample sizes to confirm these results. Conclusion: Results of this study demonstrated that extraperitoneal bilateral ureterocutaneostomy after cystectomy had advantages of less trauma, a shorter learning curve, less surgical bleeding, and quicker postoperative recovery. Although early and mid-term follow-up revealed a slightly higher incidence of hydronephrosis, the severity of complications was not high in most patients. Nevertheless, the long-term clinical efficacy of this procedure needs further study using larger sample sizes.