Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study
Abstract Objective To evaluate and compare the long-term oncologic outcomes and perioperative performance of extraperitoneal laparoscopic radical cystectomy (ELRC) versus transperitoneal laparoscopic radical cystectomy (TLRC) in patients with bladder cancer (BC). Patients and methods This retrospect...
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BMC
2025-08-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03966-0 |
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| author | Guanqun Zhu Yuxuan He Shicheng Wang Jiao Huang Rui Zhang Zongliang Zhang Kai Zhao Xinbao Yin Xiaokun Yang Zaiqing Jiang Guoyi Jiang Woong Jin Bae Ke Wang |
| author_facet | Guanqun Zhu Yuxuan He Shicheng Wang Jiao Huang Rui Zhang Zongliang Zhang Kai Zhao Xinbao Yin Xiaokun Yang Zaiqing Jiang Guoyi Jiang Woong Jin Bae Ke Wang |
| author_sort | Guanqun Zhu |
| collection | DOAJ |
| description | Abstract Objective To evaluate and compare the long-term oncologic outcomes and perioperative performance of extraperitoneal laparoscopic radical cystectomy (ELRC) versus transperitoneal laparoscopic radical cystectomy (TLRC) in patients with bladder cancer (BC). Patients and methods This retrospective single-center cohort study included 298 BC patients who underwent ELRC (n = 202) or TLRC (n = 96) between January 2020 and January 2025. Primary endpoints included overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and recurrence-free survival (RFS). Secondary endpoints were operative time, estimated blood loss, gastrointestinal recovery, and perioperative complications. Kaplan–Meier survival analysis, Cox regression, and subgroup analysis were used to evaluate outcomes and risk factors. Results The mean follow-up was 25.6 months for ELRC and 30.7 months for TLRC. There were no significant differences in projected OS (HR = 0.89, P = 0.562), CSS (HR = 0.87, P = 0.492), PFS (HR = 1.09, P = 0.693), or RFS (HR = 1.16, P = 0.453) between the two groups. ELRC was associated with significantly shorter operative time, less blood loss, faster gastrointestinal recovery, and lower incidence of ileus and infections (all P < 0.05). Multivariable analysis identified pathological T stage and ASA score as independent predictors of OS. Subgroup analysis showed no significant impact of urinary diversion type or tumor stage on survival outcomes between the two approaches. Conclusion LRC may be a feasible alternative to TLRC, with potential advantages in perioperative recovery and reduced postoperative complications, while demonstrating comparable oncologic outcomes. Prospective multicenter studies with longer-term follow-up are warranted to confirm these findings. |
| format | Article |
| id | doaj-art-5b36d70e314341e288a3eb97b7454dca |
| institution | DOAJ |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-5b36d70e314341e288a3eb97b7454dca2025-08-20T03:05:21ZengBMCWorld Journal of Surgical Oncology1477-78192025-08-0123111210.1186/s12957-025-03966-0Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort studyGuanqun Zhu0Yuxuan He1Shicheng Wang2Jiao Huang3Rui Zhang4Zongliang Zhang5Kai Zhao6Xinbao Yin7Xiaokun Yang8Zaiqing Jiang9Guoyi Jiang10Woong Jin Bae11Ke Wang12Department of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Cardiology, Huangdao District Central HospitalDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityDepartment of Urology, the Affiliated Hospital of Qingdao UniversityCatholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of KoreaDepartment of Urology, the Affiliated Hospital of Qingdao UniversityAbstract Objective To evaluate and compare the long-term oncologic outcomes and perioperative performance of extraperitoneal laparoscopic radical cystectomy (ELRC) versus transperitoneal laparoscopic radical cystectomy (TLRC) in patients with bladder cancer (BC). Patients and methods This retrospective single-center cohort study included 298 BC patients who underwent ELRC (n = 202) or TLRC (n = 96) between January 2020 and January 2025. Primary endpoints included overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and recurrence-free survival (RFS). Secondary endpoints were operative time, estimated blood loss, gastrointestinal recovery, and perioperative complications. Kaplan–Meier survival analysis, Cox regression, and subgroup analysis were used to evaluate outcomes and risk factors. Results The mean follow-up was 25.6 months for ELRC and 30.7 months for TLRC. There were no significant differences in projected OS (HR = 0.89, P = 0.562), CSS (HR = 0.87, P = 0.492), PFS (HR = 1.09, P = 0.693), or RFS (HR = 1.16, P = 0.453) between the two groups. ELRC was associated with significantly shorter operative time, less blood loss, faster gastrointestinal recovery, and lower incidence of ileus and infections (all P < 0.05). Multivariable analysis identified pathological T stage and ASA score as independent predictors of OS. Subgroup analysis showed no significant impact of urinary diversion type or tumor stage on survival outcomes between the two approaches. Conclusion LRC may be a feasible alternative to TLRC, with potential advantages in perioperative recovery and reduced postoperative complications, while demonstrating comparable oncologic outcomes. Prospective multicenter studies with longer-term follow-up are warranted to confirm these findings.https://doi.org/10.1186/s12957-025-03966-0Extraperitoneal approachMinimally invasive surgeryOncologic outcomesRadical cystectomyPerioperative management |
| spellingShingle | Guanqun Zhu Yuxuan He Shicheng Wang Jiao Huang Rui Zhang Zongliang Zhang Kai Zhao Xinbao Yin Xiaokun Yang Zaiqing Jiang Guoyi Jiang Woong Jin Bae Ke Wang Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study World Journal of Surgical Oncology Extraperitoneal approach Minimally invasive surgery Oncologic outcomes Radical cystectomy Perioperative management |
| title | Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study |
| title_full | Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study |
| title_fullStr | Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study |
| title_full_unstemmed | Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study |
| title_short | Extraperitoneal vs transperitoneal laparoscopic cystectomy: optimized surgical techniques and long-term outcomes in a single-center retrospective cohort study |
| title_sort | extraperitoneal vs transperitoneal laparoscopic cystectomy optimized surgical techniques and long term outcomes in a single center retrospective cohort study |
| topic | Extraperitoneal approach Minimally invasive surgery Oncologic outcomes Radical cystectomy Perioperative management |
| url | https://doi.org/10.1186/s12957-025-03966-0 |
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