Reproducibility of a modified posterior reconstruction during robotic intracorporeal neobladder reconfiguration

Rocco, Bernardo; Assumma, Simone; Calcagnile, Tommaso; Sangalli, Mattia; Turri, Filippo; Micali, Salvatore; Gaia, Giorgia; Bozzini, Giorgio; Sighinolfi, Maria Chiara

doi:10.1590/s1677-5538.ibju.2022.0417

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…Recently, multiple RCT trials compared open cystectomy vs. robotic cystectomy with intracorporeal urinary diversion were published ( 7 – 10 ). Different urinary diversions have been reported to be performed in either intracorporeal or extracorporeal fashion ( 11 ). A topic that has been less closely examined is the comparison of intracorporeal urinary diversion (ICUD) vs. extracorporeal urinary diversion (ECUD) following robotic-assisted laparoscopic cystectomy with different types of urinary diversion.…”

Section: Introductionmentioning

confidence: 99%

Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy

Fu,

Davis,

Ramakrishnan

et al. 2024

Int. braz j urol.

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Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches. Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed. Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate. Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.

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Section: Introductionmentioning

confidence: 99%

Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy

Fu,

Davis,

Ramakrishnan

et al. 2024

Int. braz j urol.

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“…Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases ( 2 ), mandates radical cystectomy with a 50% 5-year survival rate ( 2 ). Despite the growing use of robot-assisted radical cystectomy (RARC) ( 3 , 4 ), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported ( 5 ), in contrast to numerous open radical cystectomies ( 1 , 6 ) involving an ectopic kidney.…”

mentioning

confidence: 99%

Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia

Puliatti,

Ferretti,

Peñaranda

et al. 2024

Int. braz j urol.

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Background: The ectopic pelvic kidney, a common renal anomaly, is often smaller and malformed, with a shorter and sometimes tortuous ureter ( 1 ). Muscle-invasive bladder cancer (MIBC), constituting 15-25% of bladder cancer cases ( 2 ), mandates radical cystectomy with a 50% 5-year survival rate ( 2 ). Despite the growing use of robot-assisted radical cystectomy (RARC) ( 3 , 4 ), there is limited data on its application in ectopic kidneys. Only one RARC case has been reported ( 5 ), in contrast to numerous open radical cystectomies ( 1 , 6 ) involving an ectopic kidney. Patient and methods: After being diagnosed with T2 high-grade urothelial carcinoma, the 66-year-old patient, previously treated with multiple transurethral resections and adjuvant BCG therapy, received neoadjuvant chemotherapy. Preoperative staging CT revealed a 2.6 x 2.2 cm bladder neoformation and an ectopic right pelvic kidney. Results: Using the da Vinci Surgical System, radical cystectomy with ileal conduit (sec Wallace II) and lymphadenectomy were performed. During the demolition phase, the shorter right ureter was dissected with care to avoid damage to the renal pedicle. The reconstructive phase included intracorporeal urinary diversion (ICUD) and uretero-ileal anastomosis, facilitated by the favorable position of the kidney. The 8-hour console surgery resulted in minimal blood loss. Discharged on day 16 due to COVID-19, the patient exhibited positive outcomes. A 2-month CT follow-up revealed no cancer recurrence, metastasis, hydronephrosis, and complete regression of the lymphocele. Imaging follow-up continues without postoperative adjuvant chemotherapy. Conclusion: Robotic surgery with intracorporeal urinary diversion holds potential for right-sided pelvic kidney cases, but additional studies are necessary for validation.

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Posterior Reconstruction of the Rhabdosphincter

Rocco,

Calcagnile,

Assumma

et al. 2024

Robotic Urology

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Reproducibility of a modified posterior reconstruction during robotic intracorporeal neobladder reconfiguration

Cited by 4 publications

References 17 publications

Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy

Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy

Applicability and feasibility of robot-assisted cystectomy and intracorporeal urinary diversion in a patient with right renal pelvic ectopia

Posterior Reconstruction of the Rhabdosphincter

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