Learning Curve of a Novel Three-Port Laparoscopic Radical Cystectomy with Urinary Diversion: A Single-Center Retrospective Analysis.

Objective: Three-port laparoscopic radical cystectomy (LRC) is a novel method of radical cystectomy, which is being spread by our team in primary hospitals in our country. The purpose of this study was to evaluate the learning curve of urologists using this technique for bladder cancer patients. Methods: We retrospectively evaluated clinical data from patients with bladder cancer who received three-port LRC with urinary diversion at our medical center between January 2018 and December 2021. Consecutive cases were grouped according to different surgical years, and perioperative parameters among groups were assessed as variables for the learning curve, including operative time, estimated blood loss (EBL), lymph nodes (LN) yield, and postoperative hospital stay. Results: We assessed 154 patients who were divided into three groups, all of which were comparable in terms of preoperative characteristics. With the increase in surgical experience, the operation time of urologists is obviously reduced ( P  < .05), especially after 100 surgeries, whereas no statistically significant difference was observed in terms of EBL, LN yield, and postoperative hospital stay in the different surgical experience groups ( P  > .05). Conclusions: Our early learning curve experience indicates that the three-port LRC with urinary diversion is a safe and feasible technique that can be mastered by urologists after learning from a large sample. Given its advantages in cost and significantly improved learning curve, we recommend this technique to surgeons with extensive laparoscopic experience.