To investigate functional, oncological and complication outcomes in women undergoing robot-assisted cystectomy (RARC) with intracorporeal orthotopic neobladder.
From a multi-institutional database, we identified females with bladder cancer treated with RARC and intracorporeal orthotopic neobladder. We evaluated the continence rate, short-term oncological outcomes, and complication rates. Analyses were repeated and stratified by the status of preserving gynecological organs.
The study involved 146 patients with the median age 60 years (IQR, 51-66 years). Pelvic organ-preserving procedure (POP) was performed in 77 patients (53%). Overall daytime and nighttime continence rates were 54% and 53%, respectively. For POP, the continence rate was 58% for both daytime and nighttime continence. In the non-POP cohort, the continence rate was 50% for daytime and 49% for nighttime continence. Both groups had balanced positive surgical margin rates (5,3% for POP and 4,7% for non-POP). In the whole cohort, high-grade (Clavien-Dindo ≥3) early and late complication rate was 7,5% and 7,5%, respectively.
Robot-assisted radical cystectomy with intracorporeal orthotopic neobladder in females demonstrate excellent functional and complication outcomes. Pelvic organ-preserving cystectomy enhances urinary continence rates without adversely affecting surgical margins. Orthotopic neobladder in selected women with bladder cancer, along with pelvic organ-preserving cystectomy may be used for improved functional outcomes without compromising oncological results.
World journal of urology. 2024 Nov 02*** epublish ***
Juhana Rautiola, Alberto Martini, Laura S Mertens, Viktor Skokic, Luca Di Gianfrancesco, Carlo Andrea Bravi, Julia Heinzelbecker, Mikolaj Mendrek, Stephan Buse, Guillaume Ploussard, Hubert John, Abdullah Erdem Canda, Mevlana Derya Balbay, Sebastian Edeling, Charles Van Praet, Sami-Ramzi Leyh-Bannurah, Alexander Mottrie, Frederiek D'Hondt, Hendrik van der Poel, Camille Berquin, Karel Dacaestecker, Richard Gaston, Peter Wiklund, Abolfazl Hosseini
Department of Molecular Medicine and Surgery, Department of Pelvic Cancer, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden. ., Department of Urology, University of Cincinnati, Cincinnati, OH, USA., Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Molecular Medicine and Surgery, Department of Pelvic Cancer, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden., Oncological Urology, IRCCS Veneto Institute of Oncology, Padua, Italy., Department of Urology, The Royal Marsden NHS Foundation Trust, London, UK., Department of Urology and Pediatric Urology, Saarland University Medical Center and Saarland University, Homburg/Saar, Germany., Department of Urology, Urologic Oncology and Robot-assisted Surgery, St. Antonius Hospital, Gronau, Germany., Department of Urology, Alfried Krupp Krankenhaus, Essen, Germany., Department of Urology, La Croix du Sud Hospital, Toulouse, France., Department of Urology, Cantonal Hospital Winterthur, Winterthur, Switzerland., Department of Urology, Koç University School of Medicine, Istanbul, Turkey., Department of Urology, Vinzenz Hospital, Hannover, Germany., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Urology, OLV Hospital, Aalst, Belgium., Department of Urology, AZ Maria Middelares Hospital, Ghent, Belgium., Department of Urology, Clinique Saint Augustin, Bordeaux, France., Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.