Robot-assisted radical cystectomy and intracorporeal urinary diversion - safe and reproducible?

Content Provider	Europe PMC
Author	Sim, Allen Balbay, Mevlana Derya Todenhöfer, Tilman Aufderklamm, Stefan Halalsheh, Omar Mischinger, Johannes Böttge, Johannes Rausch, Steffen Bier, Simone Stenzl, Arnulf Gakis, Georgios Schwentner, Christian Canda, Abdullah Erdem
Copyright Year	2015
Abstract	IntroductionRobot–assisted radical cystectomy (RARC) plus intracorporeal urinary diversion is feasible. Few centers worldwide demonstrated comparable functional and oncologic outcomes. We reported a large series of RARC and intracorporeal diversion to assess its feasibility and reproducibility.Material and methodsWe identified 101 RARCs in 82 men and 19 women (mean age 68.3 years) from October 2009 to October 2014. The patients underwent RARC and pelvic lymphadenectomy followed by intracorporeal urinary diversion (ileal conduit/ neobladder). Out of the 101 patients, 28 (27.7%) received intracorporeal ileal conduits and 73 (72.3%) intracorporeal neobladders. Studer pouch was performed in all the patients who underwent intracorporeal neobladder formation. Perioperative, functional and oncologic results including CSS and OS are reported.ResultsMean operative time was 402.3 minutes (205–690) and blood loss was 345.3 ml (50–1000). The mean hospital stay was 17.1 days (5–62). All the surgeries were completed with no open conversion. Minor complications (Grade I and II) were reported in 27.7% of patients while major complications (grade III and above) were reported in 36.6% of patients. The mean nodal yield was 20.6 (0–46). Positive ureteric margins were found in 8.9% of patients. The average follow–up was 27.5 months (1–52). Daytime continence could be achieved in 89.2% of patients who underwent intracorporeal neobladder. The 3–year cancer specific survival (CSS) and overall survival (OS) was 80.2% and 69.8% respectively.ConclusionsRARC with intracorporeal diversion is safe and reproducible in ‘non–pioneer’ tertiary centers with robotic expertise having acceptable operative time and complications as well as comparable functional and oncologic outcomes.
ISSN	20804806
Journal	Central European Journal of Urology
Volume Number	68
PubMed Central reference number	PMC4408389
Issue Number	1
PubMed reference number	25914833
e-ISSN	20804873
DOI	10.5173/ceju.2015.01.466
Language	English
Publisher	Polish Urological Association
Publisher Date	2014-12-31
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright by Polish Urological Association
Subject Keyword	radical cystectomy neobladder ileal conduit intracorporeal diversion robot–assisted laparoscopy
Content Type	Text
Resource Type	Article
Subject	Urology