Minimally invasive VS open radical cystectomy in surgical management of urinary bladder cancer / Ayman Abdelhameed Mohamed Elhanafy ; Supervised Hatem Ahmed Aboulkassem , Elsayed Ashraf Hussein Khalil , Mahmoud Amr Abdelhakim

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical )

Objective:This feasibility study on bladder cancer patients aimed to compare MIRC versus conventional ORC regarding pathological, operative, and postoperativeoutcomes. Methods:This study is a randomized controlled trial, sixty candidates for radical cystectomy were recruited and allocated to two groups thirty patients each, ORC group and MIRC group. Outcome measures:operative time, EBL, blood transfusion, complications, pT stage, pathological type, retrieved LNs count,the number of positive LNs, time to solids oral intake, hospital LOS and postoperative opioid requirementoutcomes between MIRC and ORC. Results:On comparing the outcomes between the two groups, MIRC showed a significantly higher mean LN yield than ORC (p=0.004), the operative time was significantly longer in the MIRC group (P<0.001). The overall trend toward lower EBLand lower blood transfusion rate in the MIRC group, but this did not reach statistical significance (p=0.119, p=0.207 respectively). We found no statistically significant difference in postoperativehigh-grade complications between the two groups(p=0.519). time to regular oral diet was significantly shorter for MIRC (p=0.031). hospital LOS was significantly shorter for the MIRC group (p=0.001) and we found a statistically significant difference regarding the lower opioid requirement in the MIRC group (p=0.033)

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