Robotic Intracorporeal Orthotopic Neobladder during Radical Cystectomy in 132 Patients

Desai, Mihir; Gill, Inderbir S.; Abreu, André Luís de Castro; Hosseini, Abolfazl; Nyberg, Tommy; Adding, Christofer; Laurin, Oscar; Collins, Justin; Miranda, Gus; Goh, Alvin C.; Aron, Monish; Wiklund, Peter

doi:10.1016/j.juro.2014.06.087

Cited by 110 publications

(90 citation statements)

References 13 publications

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“…In a series of 132 patients who had undergone intracorporeal diversion an average operative time of 7.6 hours was reported. [18] As is the case in every surgical intervention, we think that our operative time in RCC will decrease in parallel with the increase in the number of our patients. In various series lesser amount of perioperative blood loss, and decrease in hematocrit levels were indicated when compared with open surgery with an average blood loss ranging between 273, and 473 mL.…”

Section: Discussionmentioning

confidence: 90%

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Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

İslamoğlu

Anıl

Erol

et al. 2018

Turkish Journal of Urology

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Objective: To present the surgical and pathological results of robotic radical cystectomy (RRC) operations performed in our clinic. Material and methods:A total of 18 patients, who underwent RRC and intracorporeal urinary diversion between October 2016 and September 2017 for clinically localized bladder cancer in our clinic, were included in the study. The results were evaluated under three headings. 1. operative outcomes (total operation time, perioperative blood loss, postoperative hematocrit decrease) 2. recovery period (pull-off drain day, hospitalization time) 3. oncological results (pathologic stage, surgical margin, number, and characteristics of lymph nodes removed). Complications within the postoperative 30-day period, were evaluated and the Clavien classification system was used to classify the complications. Results:The mean age of the patients was 64.4 (52-80) years. Seventeen male patients and one female patient underwent robotic cystectomy. At the operative outcomes, the mean blood loss was 325 mL, and the mean hematocrit decrease was 3.15%. The mean duration of the surgery was 471 minutes (330-630), while the median operative time was 450 minutes. Complications occured in 6 patients during the early postoperative period. Six of them (75%) had minor complications (Clavien grade 1), two patients (25%) had major complications (Clavien grade 4). Conclusion:Our initial experience with RRC is that, this surgical technique has acceptable operative, oncological and short-term clinical outcomes. However, prospective randomized studies are needed to assess whether there is a clear advantage compared to open surgery.

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Section: Discussionmentioning

confidence: 90%

“…Generally our low rate of complications was at an acceptable level, and also comparable to that of our series. [17][18][19][20] In one patient neobladder rupture (Clavien grade 4) developed on postoperative 25. day. The patient was explored, and any problem in the perfusion or blood supply of the neobladder was not observed.…”

Section: Discussionmentioning

confidence: 99%

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

İslamoğlu

Anıl

Erol

et al. 2018

Turkish Journal of Urology

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“…9,10,14,15 The initial search identified 271 articles and 16 full-text studies were assessed for eligibility; 12 of which were excluded (Fig. 3).…”

Section: Eligible Studiesmentioning

confidence: 99%

“…The total number of ureters used for ureteroeneteric anastamoses was 1217: 545 in the Bricker arm and 672 in the Wallace arm. One trial was multicentre 15 and all 4 trials were retrospective. Indications for withdrawals were described in detail for the 2 studies in which patients withdrew.…”

Section: Eligible Studiesmentioning

confidence: 99%

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Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

Davis

Burke

McDermott

et al. 2015

CUAJ

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Introduction: Data comparing the incidence of ureteroenteric strictures for Bricker and Wallace anastomoses are limited. This study compares both anastomotic techniques in terms of ureteroenteric stricture rates after radical cystectomy and ileal conduit urinary diversion. Methods: Electronic databases (Medline, EMBASE, and Cochrane database) were searched for studies comparing Bricker and Wallace ureteroeneteric anastomoses for ileal conduit urinary diversion after radical cystectomy. Meta-analyses were performed using the random effects method. The primary outcome measure was to determine differences in postoperative ureteroenteric stricture rates for both surgical techniques. Four studies describing 658 patients met the inclusion criteria. The total number of ureters used for ureteroeneteric anastomoses was 1217 (545 in the Bricker group and 672 in the Wallace group). Results: There were no significant differences in age (p = 0.472), gender (p = 0.897), duration of follow-up (p = 0.168), and duration to stricture development between groups (p = 0.439). The overall stricture rate was 29 of 1217 (2.4%); 16 of 545 ureters (2.9%) in the Bricker group and 13 of 672 ureters (1.9%) in the Wallace group. The Bricker anastomosis was not associated with a significantly higher overall stricture rate compared to the Wallace ureteroenteric anastomosis (odds ratio: 1.393, 95% confidence interval: 0.441-4.394, p = 0.572).

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Urothelial cancer

Raghavan,

Cote,

Burgess

et al. 2017

Holland‐Frei Cancer Medicine

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Overview Urothelial malignancy is one of the most common cancers in Western society and involves the bladder, urethra, ureters, and renal calyces. It is predominantly associated with smoking, industrial dyes, schistomiasis, radiation exposure, and certain geographical locations. Well‐defined molecular prognosticators have been identified and, in combination with improved staging techniques, have led to improved outcomes. Patients with nonmuscle invasive urothelial malignancy are best managed by surgical resection, often in combination with intravesical immunotherapy or chemotherapy. Muscle invasive disease is best managed by neoadjuvant cisplatin‐based chemotherapy followed by cystectomy; less robust patients are often effectively treated by cisplatin‐based chemoradiation. Patients with metastatic disease achieve response rates of up to 70% with MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin) or GC combination chemotherapy but are infrequently cured. New approaches to the management of systemic disease are predicated on recent data reflecting the importance of unblocking checkpoints for immune function and correlate with expression of PD‐L1 (programmed death‐ligand 1).

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Robotic Intracorporeal Orthotopic Neobladder during Radical Cystectomy in 132 Patients

Cited by 110 publications

References 13 publications

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

Urothelial cancer

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