Robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty

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Abstract

Background. Radical cystectomy uses laparoscopic and robotic approaches along with the open ones.

Objective: to study immediate results of robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty.

Materials and methods. Robot-assisted radical cystectomy with intracorporeal orthotopic cystoplasty was performed in 15 patients (13 male, 2 female), aged 64–76 years. Fourteen patients had bladder cancer, 1 female – a postradiation bladder fistula and microcystis. T2 stage was detected in 8 (57.1 %) patients, T3 – in 6 (42.9 %). After the operation we evaluated operation time, blood loss volume, hospital stay, functional and oncological results.

Results. Average operation time was 380 (320–560) minutes, blood loss volume – 80–200 ml, blood transfusion was not performed. Early complications (up to 30 days) were observed in 7 patients (46.7 %), late ones (90‑days) – in 6 (40.0 %). There were no cases of intestinal obstruction. Patients with ureteral-intestinal (n = 2) and reservoir-urethral (n = 1) anastomosis failure underwent percutaneous renal drainage. One patient died of acute myocardial infarction. Daytime continence was 80.0 %, nocturnal – 53.3 %. One patient died of disease progression within 7.6 observation months.

Conclusion. Robot-assisted radical cystectomy with intracorporeal urine diversion is a modern and minimally invasive method for patients with muscle-invasive bladder cancer. More experience in this field will allow to reduce surgery time and number of complications.

About the authors

B. G. Guliev

I. I. Mechnikov North-West State Medical University, Ministry of Health of Russia;
Urology Center with Robot-Assisted Surgery, Mariinsky Hospital

Author for correspondence.
Email: gulievbg@mail.ru
ORCID iD: 0000-0002-2359-6973

Department of Urology, I. I. Mechnikov North-West State Medical University, Ministry of Health of Russia

41 Kirochnaya St., Saint-Petersburg 191015, 

56 Liteynyy Prospekt, Saint-Petersburg 191014

Russian Federation

B. K. Komyakov

I. I. Mechnikov North-West State Medical University, Ministry of Health of Russia

Email: komyakovbk@mail.ru
ORCID iD: 0000-0002-8606-9791

Department of Urology

41 Kirochnaya St., Saint-Petersburg 191015

R. R. Bolokotov

Urology Center with Robot-Assisted Surgery, Mariinsky Hospital

Email: rbolotokovadiga07@rambler.ru
ORCID iD: 0000-0002-2184-5809

56 Liteynyy Prospekt, Saint-Petersburg 191014

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