Oncological and functional outcome of robotic-assisted radical cystectomy with total intracorporeal stentless J-pouch neobladder reconstruction

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-10-09 DOI:10.1002/rcs.2583

Hao Xiang Chen, Chi-Ping Huang

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Abstract

Background

Robotic-assisted radical cystectomy (RARC) with neobladder reconstruction has gained popularity in recent years.

Methods

We conducted a retrospective study of 17 consecutive patients who underwent RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent by a single experienced surgeon to evaluate perioperative, oncological and functional outcomes.

Results

The median follow-up duration was 32.8 months (range: 17.4–59.0 months), and the 2-year disease-free survival rate was 88.2%. Five out of 12 patients were totally continent, and none required more than one pad per day. The overall complication rate was 41.2%, and hydronephrosis was the most common adverse event. The renal function remained stable, and no long-term renal function impairment was detected.

Conclusion

Our study suggests that RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent is a safe and feasible option for the treatment of muscle-invasive bladder cancer, with good oncological and functional outcomes.

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机器人辅助根治性膀胱切除术与全体内无支架J袋新膀胱重建的肿瘤和功能结果。

背景：近年来，机器人辅助膀胱根治术（RARC）和新膀胱重建术越来越受欢迎。方法：我们对17名连续接受RARC的患者进行了回顾性研究，这些患者由一名经验丰富的外科医生在没有输尿管支架的情况下进行了完全体内J袋新膀胱重建，以评估围手术期、肿瘤学和功能结果。结果：中位随访时间为32.8个月（范围：17.4-59.0个月），2年无病生存率为88.2%。12名患者中有5名完全是大陆患者，没有一名患者每天需要一个以上的衬垫。总的并发症发生率为41.2%，肾积水是最常见的不良事件。肾功能保持稳定，未发现长期肾功能损害。结论：我们的研究表明，RARC与无输尿管支架的完全体内J袋新膀胱重建术是治疗肌肉浸润性膀胱癌症的一种安全可行的选择，具有良好的肿瘤学和功能结果。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.