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Abstract
Objectives: To report the perioperative outcomes of 131 cases of robot-assisted radical cystectomy for bladder cancer and extracorporeal/intracorporeal urinary diversion performed at the Department of Urology of Binh Dan hospital for 3 years.
Materials and Methods: In 3 years from December 31st 2016 to October 31st 2019, one hundred and thirty one (131) patients suffering from bladder cancer with indication of radical cystectomy had transurethral resection of bladder tumor (TURBT) for diagnosis followed by robot-assisted radical cystectomy and simple urinary diversion or extracorporeal or intracorporeal orthotopic ileal neobladder using the robot da Vinci™ Si system with 4th arm. The perioperative outcomes were documented and reported.
Results: One hundred and thirty one patients suffering from bladder tumor with indication of radical cystectomy with mean age: 59 ± 9.51 (32-83), 110 male (84%) and 21 female patients (16%). BMI: 22.5 ± 3 (16.9-30.4). Number of ports: 6 ports (4 ports for robotic arms). Radical cystectomy performed according to the anatomic foundation technique presented by Guru followed by standard lymphadenectomy. Urinary diversion after cystectomy: cutaneous ureterostomy: 29/131 cases (22.1%); extracorporeal ileal conduit
urinary diversion: 37/131 cases (28.2%); extracorporeal orthotopic neobladder (Hautmann): 44/131 cases (33.6%); intracorporeal orthotopic neobladder (Gaston): 21 / 131 cases (16%). Mean operative time: 391.8 minutes (297-660); Mean estimated blood loss: 387.5 mL (200-600). Mean drainage time: 7 days (6-10). Postoperative hospital stay: 10.7 days (8-30). Tumor histology: TCC tumors (transitional cell carcinoma): 122/131 cases (93.1%), adenocarcinoma tumors: 9/131 cases (6.8%); non-muscle invasive TCC tumors:
7/131 cases (5.3%), muscle invasive TCC tumors: 124/131 cases (94.6%), positive lymph nodes in 10/131 cases (7.6%). Positive surgical margin: 8/131 cases (6.1%). Early post-operative complications: 37/131 (28.2%); Late post-operative complications: 22/131 cases (16.8%).
Conclusions: Our series of 131 cases of robot-assisted radical cystectomy and ileal conduit urinary diversion have achieved encouraging perioperative outcomes. More cases of intracorporeal orthotopic ileal neobladder are needed to be performed in order to refine this technique, which still remains the most challenging technique for the surgeon and the most expected technique for the patients.
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| Published | 17-01-2025 | |
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| Issue | No. 61 (2020) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.2020.61.1 | |
| Keywords | Phẫu thuật robot, cắt bàng quang tận gốc, chuyển lưu nước tiểu qua ống hồi tràng, tạo hình bàng quang bằng hồi tràng nối thẳng Robot - assisted surgery, radical cystectomy, ileal urinary diversion, intracorporeal orthotopic ileal neocystoplasty |
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