TY - JOUR
T1 - Robot-assisted radical cystoprostatectomy: Analysis of the complications and oncological and functional aspects
AU - Gausa, L.
AU - Gaya, J. M.
AU - Kanashiro, A.
AU - Palou, J.
AU - Villavicencio, H.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - © 2016 AEU Objectives To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. Materials and methods From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases. Results The mean blood loss was 300 mL. No case required conversion to open surgery. The median number of lymph nodes extracted was 16 (range 3-33). Pathology revealed 16 pT0, 15 pTis,-pT1-pTa and 44 muscle-invasive tumours, 8 pN+ and 1 with positive margins. The mean hospital stay was 9 days. With a median follow-up of 16 months, 9 (13%) patients were readmitted after the discharge, most for infections associated with the vesical catheter and other catheters. Forty patients (59.7%) presented complications (most were Clavien grade 1-2). There was recurrence during the follow-up in 4 cases (6%), and 4 (5.9%) patients died from cancer. Nineteen (28.3%) patients had complications after 30 days, most of which were urinary tract infections. Of the 47 patients with a neobladder, 45 (96%) had proper daytime continence and 42 (89%) had proper nighttime continence. Ninety percent and 64% of the patients with previously normal sexual function and reduced sexual function, respectively, were able to preserve sexual function with or without drug treatment. Conclusions Robot-assisted radical cystectomy plus lymphadenectomy, with extracorporeal reconstruction of the urinary diversion, offers good oncological and functional results without increasing the number of complications.
AB - © 2016 AEU Objectives To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results. Materials and methods From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases. Results The mean blood loss was 300 mL. No case required conversion to open surgery. The median number of lymph nodes extracted was 16 (range 3-33). Pathology revealed 16 pT0, 15 pTis,-pT1-pTa and 44 muscle-invasive tumours, 8 pN+ and 1 with positive margins. The mean hospital stay was 9 days. With a median follow-up of 16 months, 9 (13%) patients were readmitted after the discharge, most for infections associated with the vesical catheter and other catheters. Forty patients (59.7%) presented complications (most were Clavien grade 1-2). There was recurrence during the follow-up in 4 cases (6%), and 4 (5.9%) patients died from cancer. Nineteen (28.3%) patients had complications after 30 days, most of which were urinary tract infections. Of the 47 patients with a neobladder, 45 (96%) had proper daytime continence and 42 (89%) had proper nighttime continence. Ninety percent and 64% of the patients with previously normal sexual function and reduced sexual function, respectively, were able to preserve sexual function with or without drug treatment. Conclusions Robot-assisted radical cystectomy plus lymphadenectomy, with extracorporeal reconstruction of the urinary diversion, offers good oncological and functional results without increasing the number of complications.
KW - Urinary diversion
KW - Neobladder
KW - Bladder cancer
KW - Radical cystectomy
KW - Robot
UR - https://dialnet.unirioja.es/servlet/articulo?codigo=5959917
U2 - 10.1016/j.acuro.2016.06.009
DO - 10.1016/j.acuro.2016.06.009
M3 - Article
SN - 0210-4806
VL - 41
SP - 267
EP - 273
JO - Actas Urologicas Espanolas
JF - Actas Urologicas Espanolas
IS - 4
ER -