Robot-assisted Cystectomy with Intracorporeal Urinary Diversion After Pelvic Irradiation for Prostate Cancer: Technique and Results from a Single High-volume Center

Piazza, Pietro; Rosiello, Giuseppe; Chacón, Victor Tamés; Puliatti, Stefano; Amato, Marco; Farinha, Rui; Schiavina, Riccardo; Brunocilla, Eugenio; Berquin, Camille; Develtere, Dries; Sinatti, Céline; Puyvelde, Hannah Van; Groote, Ruben De; Schatteman, Peter; Naeyer, Geert De; D’Hondt, Frederiek; Mottrie, Alexandre

doi:10.1016/j.eururo.2021.03.023

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…And when we compared the levels of in ammatory factors between the two groups, we also saw that the in ammation levels in the research group were low on postoperative T1 and T2, which could initially validate our point. Furthermore, in a previous study, we also found that Piazza et al indicated that patients recovered better with the DSRS "3 + 1" model of cystectomy, which is also consistent with our view [24]. Subsequently, we also found that the incidence of adverse reactions was lower in the research group than in the control group, further suggesting that the DSRS "3 + 1" model is safer.…”

Section: Discussionsupporting

confidence: 91%

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Comparison of effectiveness and safety of Da Vinci robot’s “3+1” and “4+1” modes of treatment for colorectal cancer

Wang¹,

Wu²,

Huang³

et al. 2023

Preprint

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Objective To compare the effectiveness of the Da Vinci Surgical Robot System (DSRS) “3 + 1” and “4 + 1” models for colorectal cancer (CRC).Methods A total of 107 patients with CRC admitted to our hospital from February 2021 to May 2022 were selected for the retrospective analysis. Of these, 57 patients underwent the DSRS “4 + 1” model (control group), while the rest 50 underwent the DSRS “3 + 1” model (research group). The operation time, intraoperative bleeding, number of lymph nodes detected, time of first postoperative urinary catheter removal, time of first feeding, time of first venting and hospitalization were compared between the two groups. The changes of white blood cell (WBC) and C-reactive protein (CRP) levels before and after surgery were detected, and patients’ adverse effects and treatment costs between surgery and hospital discharge were counted. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used to assess the psychological state of the patients.Results There was no difference in operative time, intraoperative bleeding, and number of lymph nodes detected between both groups (P > 0.05), while time to first postoperative urinary catheter removal, time to first feeding, time to first venting, length of stay (LOS), postoperative inflammatory factor levels, incidence of adverse events, and treatment costs were all lower in the research group than in the control group (P < 0.05). SAS and SDS scores decreased after treatment in both groups, but the decrease was more obvious in the research group (P < 0.05).Conclusion Both DSRS “4 + 1” and “3 + 1” modes have better treatment effects for CRC. But the “3 + 1” mode has higher safety and lower treatment cost, which can significantly improve the postoperative recovery process of patients and is more worthy to be promoted in clinical practice.

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Section: Discussionsupporting

confidence: 91%

“…However, the number of Clavien Dindo grade III was less in the research group than in the control group (P < 0.05) (Table 3). 24) yuan (P < 0.05). In addition, the total cost of hospitalization was also lower in the research group than in the control group (P < 0.05) (Fig.…”

Section: Safety Comparisonmentioning

confidence: 91%

Comparison of effectiveness and safety of Da Vinci robot’s “3+1” and “4+1” modes of treatment for colorectal cancer

Wang¹,

Wu²,

Huang³

et al. 2023

Preprint

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“…Other more recent observational reports have confirmed high complication rates after UD with benign indications for surgery, with 90-day high-grade complication events between 42% and 48% [47,48]. Specifically addressing RARC with UD in patients with severe urinary problems after pelvic irradiation for prostate cancer, a newly published single-centre observational study with no comparison to open surgery, reported a series of 32 patients subjected to incontinent UD [49 ▪ ]. Assessment of complications in this surgically challenging patient group revealed 16% and 28% high-grade events at 30 and 90 days, among whom five patients needed a reoperation after a median of 12 days and seven patients were readmitted after a median of 28 days for infectious complications (pyelonephritis n = 6 and pelvic abscess n = 1).…”

Section: Benign Vs Malign Indication For Urinary Diversionmentioning

confidence: 97%

Urinary diversions for benign and oncologic indications: what did we learn about short term complications in the last 24 months?

Bobjer

2021

Current Opinion in Urology

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Purpose of reviewUrinary diversion (UD) with or without cystectomy is a procedure with high short term complication rates. In this review, we summarize the most relevant findings of the last 2 years.Recent findingsThe use of a prophylactic mesh decreases the risk of parastomal hernia after ileal conduit (IC) surgery without adding mesh-related complications according to a recent randomized multicentre trial. Robot-assisted surgery is increasingly applied for UD and is evolving from extra- to intra-corporeal reconstruction in both continent and incontinent diversions, but there is still a need for appropriately designed studies assessing both short- and long-term complications. Promising techniques to decrease ureterointestinal stricture rates have been reported from small series, such as retrosigmoid placement of the proximal IC to avoid transpositioning of the left ureter, or in robot-assisted surgery the use of indocyanine green with near-infrared light to improve visualisation of distal ureteral viability.SummaryMost recent reports derive from observational data. Appropriate randomized studies are warranted for the evaluation of new techniques to be implemented in a surgical area that still is associated with high complication rates.

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“…Surgery can be considered a treatment option for severe radiationinduced bladder injuries that do not respond to conventional treatments. [48][49] Surgical options include (1) selective embolization or ligation of the internal iliac artery; (2) percutaneous nephrostomy; (3) percutaneous ureterostomy or intestinal conduit; (4) cystectomy.…”

Section: Surgerymentioning

confidence: 99%

“…50 Urinary diversion may be considered for intractable severe radiation-induced bladder injuries, including methods such as percutaneous nephrostomy, ureterostomy, and transverse colonic conduit. 48 Among these, intestinal conduits are the preferred method, using a transverse colon or non-irradiated ileum and ureters for urinary diversion. In patients undergoing urinary diversion, more than 50% Urinary diversion surgery can be considered if severe bleeding persists after the above treatments.…”

Section: Surgerymentioning

confidence: 99%

Clinical Guidelines for the Prevention and Treatment of Radiation‐induced Bladder Injury

Wang,

Zhang,

Yuan

2024

Precision Radiation Oncology

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Radiation‐induced bladder injury is a common complication after pelvic radiotherapy. Few studies exist on diagnosing and treating radiation‐induced bladder injury, with no established guidelines or consensus in China or internationally. Clinical physicians' diagnosis and treatment of radiation‐induced bladder injury are primarily based on their own clinical experience, and there is an urgent need for unified guidelines to standardize clinical diagnosis and treatment. Therefore, the Chinese Radiation Therapy Oncology Group, China Anti‐Cancer Association Tumor Support Therapy Committee, and China Anti‐Cancer Association Tumor Radiation Protection Committee gathered experts to develop Chinese clinical practice guidelines, guiding diagnosing and treating radiation‐induced bladder injury. The development of these guidelines adopted the grading system of evidence quality and recommendation strength (GRADE).

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Robot-assisted Cystectomy with Intracorporeal Urinary Diversion After Pelvic Irradiation for Prostate Cancer: Technique and Results from a Single High-volume Center

Cited by 9 publications

References 38 publications

Comparison of effectiveness and safety of Da Vinci robot’s “3+1” and “4+1” modes of treatment for colorectal cancer

Comparison of effectiveness and safety of Da Vinci robot’s “3+1” and “4+1” modes of treatment for colorectal cancer

Urinary diversions for benign and oncologic indications: what did we learn about short term complications in the last 24 months?

Clinical Guidelines for the Prevention and Treatment of Radiation‐induced Bladder Injury

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