【Objective】 To investigate the clinical effects of extra-peritoneal versus trans-peritoneal open radical cystectomy. 【Methods】 The clinical data of 83 patients with muscle invasive bladder cancer was analyzed retrospectively in our hospital from June 2001 to December 2011. Forty-five patients underwent extra-peritoneal radical cystectomy with ileal conduit. The remaining 38 were submitted to the trans-peritoneal technique. 【Results】 Patients in extra-peritoneal group had shorter operating time (240 min)

less average blood loss (300 mL)

shorter anal exsufflation time (48.6 h)

shorter out of bed activity time (4.5 d) and shorter postoperative stay (12.5 d) compared to the patients in trans-peritoneal group (P 0.05). 【Conclusion】 Compared to trans-peritoneal approach

the extra-peritoneal radical cystectomy is associated with less intraoperative average blood loss

small interference of abdominal cavity and quicker recovery. It is an effective treatment for muscle invasive bladder cancer

especially for the bladder cancer under stage T2.