Robotic Radical Cystectomy for Bladder Cancer: Surgical and Pathological Outcomes in 100 Consecutive Cases

Pruthi, Raj S.; Nielsen, Matthew E.; Nix, Jeff; Smith, Angela; Schultz, Heather; Wallen, Eric

doi:10.1016/j.juro.2009.10.027

Cited by 169 publications

(93 citation statements)

References 22 publications

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“…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. [19,20] In our series average blood loss was 325 mL, and drop in hematocrit was 3.15% which were within acceptable limits.. As for hospital stays, we think that for a major surgery 12 days should not be considered as a prolonged hospital stay, and as experiences accumulate, lymphatic drainage which develops after lymphadenectomy may be prevented, and drain withdrawal, and discharge times may be performed at an earlier date. Therefore conduction of a randomized study which will compare open, and robotic surgery will be more appropriate.…”

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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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: 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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“…The question naturally arises then, can a new procedure like RARC achieve results with same or better oncological and functional success than ORC? Pruthi and his team followed a total of 100 consecutive patients who underwent SCRRC from 2006 to 2009 for clinically localized bladder cancer [26]. Pruthi et al found that in no SCRRC procedure was there a positive surgical margin and 8% of patients subsequently suffered a major complication (Clavien grade 3 or higher) [26].…”

Section: Oncological Outcomesmentioning

confidence: 99%

“…Pruthi and his team followed a total of 100 consecutive patients who underwent SCRRC from 2006 to 2009 for clinically localized bladder cancer [26]. Pruthi et al found that in no SCRRC procedure was there a positive surgical margin and 8% of patients subsequently suffered a major complication (Clavien grade 3 or higher) [26]. At a mean followup of 21 months, 15 patients had disease recurrence with 6 eventually succumbing to the disease [26].…”

Section: Oncological Outcomesmentioning

confidence: 99%

“…Pruthi et al found that in no SCRRC procedure was there a positive surgical margin and 8% of patients subsequently suffered a major complication (Clavien grade 3 or higher) [26]. At a mean followup of 21 months, 15 patients had disease recurrence with 6 eventually succumbing to the disease [26]. Pruthi and colleagues concluded that with their relatively large study to date, SCRRC for the treatment of bladder cancer provided satisfactory outcomes [26].…”

Section: Oncological Outcomesmentioning

confidence: 99%

“…At a mean followup of 21 months, 15 patients had disease recurrence with 6 eventually succumbing to the disease [26]. Pruthi and colleagues concluded that with their relatively large study to date, SCRRC for the treatment of bladder cancer provided satisfactory outcomes [26]. Nix et al published a subsequent landmark prospective randomized trial of ORC versus SCRRC in 41 patients and discovered that compared with ORC, SCRRC was associated with less intraoperative EBL (258 vs. 575 ml P<0.001), earlier time-to-bowel movement and reduced narcotic use for pain relief [27].…”

Section: Oncological Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

Patel

Babbar

Hemal

2011

Indian J Surg Oncol

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The rise of robotic surgery is transforming medicine. In many ways, urology has taken charge in pioneering a new era of minimally invasive surgery with the emergence of the robot. The unprecedented dissecting precision and the dynamic three-dimensional, high definition view of the surgical field are undoubtedly revolutionizing the field of urology. These unique attributes of robotic surgery confer enormous advantages in dealing with urooncological surgery. The robotic revolution began nearly a decade ago with surgeon-controlled robotic radical prostatectomy and has since expanded to include radical cystectomies and partial nephrectomies. There have been numerous landmark studies published showing that robotic surgery provides comparable oncological and functional outcomes against traditional open or laparoscopic surgery. As a result, it becomes exceedingly imperative that urologists and the oncological community remain up-todate regarding these developments and appreciate the oncological outcomes of surgeon-controlled robotic surgery. This review will assess the impact surgeon-controlled robotic surgery has had in the field of urologic oncology.

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Changes in Racial Disparities in Mortality After Cancer Surgery in the US, 2007-2016

et al. 2020

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IMPORTANCE Racial disparities are well documented in cancer care. Overall, in the US, Black patients historically have higher rates of mortality after surgery than White patients. However, it is unknown whether racial disparities in mortality after cancer surgery have changed over time.OBJECTIVE To examine whether and how disparities in mortality after cancer surgery have changed over 10 years for Black and White patients overall and for 9 specific cancers. DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional study, national Medicare data were used to examine the 10-year (January 1, 2007, to November 30, 2016 changes in postoperative mortality rates in Black and White patients. Data analysis was performed from August 6 to December 31, 2019. Participants included fee-for-service beneficiaries enrolled in Medicare Part A who had a major surgical resection for 9 common types of cancer surgery: colorectal, bladder, esophageal, kidney, liver, ovarian, pancreatic, lung, or prostate cancer. EXPOSURES Cancer surgery among Black and White patients.MAIN OUTCOMES AND MEASURES Risk-adjusted 30-day, all-cause, postoperative mortality overall and for 9 specific types of cancer surgery. RESULTSA total of 870 929 cancer operations were performed during the 10-year study period. In the baseline year, a total of 103 446 patients had cancer operations (96 210 White patients and 7236 Black patients). Black patients were slightly younger (mean [SD] age, 73.0 [6.4] vs 74.5 [6.8] years), and there were fewer Black vs White men (3986 [55.1%] vs 55 527 [57.7%]). Overall national mortality rates following cancer surgery were lower for both Black (−0.12%; 95% CI, −0.17% to −0.06% per year) and White (−0.14%; 95% CI, −0.16% to −0.13% per year) patients. These reductions were predominantly attributable to within-hospital mortality improvements (Black patients: 0.10% annually; 95% CI, −0.15% to −0.05%; P < .001; White patients: 0.13%; 95% CI, −0.14% to −0.11%; P < .001) vs between-hospital mortality improvements. Across the 9 different cancer surgery procedures, there was no significant difference in mortality changes between Black and White patients during the period under study (eg, prostate cancer: 0.35; 95% CI, 0.02-0.68; lung cancer: 0.61; 95% CI, −0.21 to 1.44). CONCLUSIONS AND RELEVANCEThese findings offer mixed news for policy makers regarding possible reductions in racial disparities following cancer surgery. Although postoperative cancer surgery mortality rates improved for both Black and White patients, there did not appear to be any narrowing of the mortality gap between Black and White patients overall or across individual cancer surgery procedures.

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Robotic Radical Cystectomy for Bladder Cancer: Surgical and Pathological Outcomes in 100 Consecutive Cases

Abstract: We report a relatively large and maturing experience with robotic radical cystectomy for the treatment of bladder cancer providing acceptable surgical and pathological outcomes. These results support continued efforts to refine the surgical management of high risk bladder cancer.

Cited by 169 publications

References 22 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

The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

Changes in Racial Disparities in Mortality After Cancer Surgery in the US, 2007-2016

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