Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 934-940 |
| Number of pages | 7 |
| Journal | European Urology |
| Volume | 73 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 1 2018 |
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Keywords
- Bladder cancer
- Intracorporeal urinary diversion
- Orthotopic neobladder
- Padua ileal bladder
- Radical cystectomy
- Robotic intracorporeal neobladder
- Robotic surgery
Cite this
Robotic Intracorporeal Padua Ileal Bladder: Surgical Technique, Perioperative, Oncologic and Functional Outcomes. / Simone, G.; Papalia, R.; Misuraca, L.; Tuderti, G.; Minisola, F.; Ferriero, M.; Vallati, G.; Guaglianone, S.; Gallucci, M.
In: European Urology, Vol. 73, No. 6, 01.06.2018, p. 934-940.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Robotic Intracorporeal Padua Ileal Bladder: Surgical Technique, Perioperative, Oncologic and Functional Outcomes
AU - Simone, G.
AU - Papalia, R.
AU - Misuraca, L.
AU - Tuderti, G.
AU - Minisola, F.
AU - Ferriero, M.
AU - Vallati, G.
AU - Guaglianone, S.
AU - Gallucci, M.
N1 - LR: 20180519; CI: Copyright (c) 2016; JID: 7512719; CIN: Transl Androl Urol. 2017 Dec;6(6):1187-1189. PMID: 29354509; OTO: NOTNLM; 2016/08/29 00:00 [received]; 2016/10/11 00:00 [accepted]; 2016/10/27 06:00 [pubmed]; 2016/10/27 06:00 [medline]; 2016/10/27 06:00 [entrez]; ppublish
PY - 2018/6/1
Y1 - 2018/6/1
N2 - BACKGROUND: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder reconstruction is a challenging procedure. The need for surgical skills and the long operative times have led to concern about its reproducibility. OBJECTIVE: To illustrate our technique for RARC and totally intracorporeal orthotopic Padua ileal bladder. DESIGN, SETTING, AND PARTICIPANTS: From August 2012 to February 2014, 45 patients underwent this technique at a single tertiary referral centre. SURGICAL PROCEDURE: RARC, extended pelvic lymph node dissection, and intracorporeal partly stapled neobladder. Surgical steps are demonstrated in the accompanying video. MEASUREMENTS: Demographics, clinical, and pathological data were collected. Perioperative, 2-yr oncologic and 2-yr functional outcomes were reported. RESULTS AND LIMITATIONS: Intraoperative transfusion or conversion to open surgery was not necessary in any case and intracorporeal neobladder was successfully performed in all 45 patients. Median operative time was 305min (interquartile range [IQR]: 282-345). Median estimated blood loss was 210ml (IQR: 50-250). Median hospital stay was 9 d (IQR: 7-12). The overall incidence of perioperative, 30-d and 180-d complications were 44.4%, 57.8%, and 77.8%, respectively, while severe complications occurred in17.8%, 17.8%, and 35.5%, respectively. Two-yr daytime and night-time continence rates were 73.3% and 55.5%, respectively. Two-yr disease free survival, cancer specific survival, and overall survival rates were 72.5%, 82.3%, and 82.4%, respectively. The small sample size and high caseload of the centre might affect the reproducibility of these results. CONCLUSIONS: Our experience supports the feasibility of totally intracorporeal neobladder following RARC. Operative times and perioperative complication rates are likely to be reduced with increasing experience. PATIENT SUMMARY: We report the outcomes of our first 45 consecutive patients who underwent robot-assisted radical cystectomy with intracorporeal neobladders. Perioperative, oncologic, and functional outcomes support this technique as a feasible and safe surgical option in tertiary referral centres.
AB - BACKGROUND: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder reconstruction is a challenging procedure. The need for surgical skills and the long operative times have led to concern about its reproducibility. OBJECTIVE: To illustrate our technique for RARC and totally intracorporeal orthotopic Padua ileal bladder. DESIGN, SETTING, AND PARTICIPANTS: From August 2012 to February 2014, 45 patients underwent this technique at a single tertiary referral centre. SURGICAL PROCEDURE: RARC, extended pelvic lymph node dissection, and intracorporeal partly stapled neobladder. Surgical steps are demonstrated in the accompanying video. MEASUREMENTS: Demographics, clinical, and pathological data were collected. Perioperative, 2-yr oncologic and 2-yr functional outcomes were reported. RESULTS AND LIMITATIONS: Intraoperative transfusion or conversion to open surgery was not necessary in any case and intracorporeal neobladder was successfully performed in all 45 patients. Median operative time was 305min (interquartile range [IQR]: 282-345). Median estimated blood loss was 210ml (IQR: 50-250). Median hospital stay was 9 d (IQR: 7-12). The overall incidence of perioperative, 30-d and 180-d complications were 44.4%, 57.8%, and 77.8%, respectively, while severe complications occurred in17.8%, 17.8%, and 35.5%, respectively. Two-yr daytime and night-time continence rates were 73.3% and 55.5%, respectively. Two-yr disease free survival, cancer specific survival, and overall survival rates were 72.5%, 82.3%, and 82.4%, respectively. The small sample size and high caseload of the centre might affect the reproducibility of these results. CONCLUSIONS: Our experience supports the feasibility of totally intracorporeal neobladder following RARC. Operative times and perioperative complication rates are likely to be reduced with increasing experience. PATIENT SUMMARY: We report the outcomes of our first 45 consecutive patients who underwent robot-assisted radical cystectomy with intracorporeal neobladders. Perioperative, oncologic, and functional outcomes support this technique as a feasible and safe surgical option in tertiary referral centres.
KW - Bladder cancer
KW - Intracorporeal urinary diversion
KW - Orthotopic neobladder
KW - Padua ileal bladder
KW - Radical cystectomy
KW - Robotic intracorporeal neobladder
KW - Robotic surgery
U2 - S0302-2838(16)30721-7 [pii]
DO - S0302-2838(16)30721-7 [pii]
M3 - Article
VL - 73
SP - 934
EP - 940
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 6
ER -