The Feasibility of Modified Laparoscopic Female Radical Cystectomy: A Procedural Guide and Comparison with Traditional Technique

Abstract Females are generally less likely to develop carcinoma of the urinary bladder compared with melas. Despite radical cystectomy (RC) being an effective surgical technique, its usage in women is limited due to the decreased incidence and potential postoperative complications. We sought to evaluate the safety and feasibility of a novel modified laparoscopic radical cystectomy (MLRC) for female patients with bladder cancer and introduce the modified procedural stepwise. The retrospective cohort study spanned from January 1, 2018, to September 30, 2023, and included 45 female patients who underwent RC. Perioperative data comparison between the MLRC group (25 patients) and the traditional laparoscopic radical cystectomy (TLRC) group (20 patients) was conducted, with differences being deemed significant at P < 0.05. All operations were performed successfully without conversion to open surgery. The MLRC group exhibited less %sCre change (P < 0.001), less estimated blood loss (EBL) (P < 0.001), shorter operative time (P < 0.001), shorter pelvic lymph node dissection (PLND) time (P < 0.001), shorter first postoperative defecation (FPD) time (P < 0.001), and fewer complications (P < 0.05). However, the postoperative hospital stay, urinary reconstruction, overall survival, local recurrence or distant metastasis, and American Society of Anaesthesiology (ASA) score showed no statistical difference. Patients were followed up for 3 to 65 months, with a median of 27 months.MLRC is a safe and feasible procedure that could improve perioperative outcomes compared to traditional procedures.