International journal of urology : official journal of the Japanese Urological Association · 2025
Open Versus Robotic Radical Cystectomy With Intracorporeal Neobladder: A Decade-Long Single-Surgeon Experience.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Tillu Neeraja, Dovey Zachary, Choudhary Manish, Venkatesh Arjun, Eraky Ahmed, Campistol Miriam, Bada Maida, Rangchi Arshia, Jabo Mohammed, Mir Carmen, Petitti Tommasangelo, Zaytoun Osama, Buscarini Maurizio
Аннотация
INTRODUCTION: This single-surgeon, long-term study aims to evaluate open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) with Studer urinary diversion in bladder cancer patients in terms of perioperative, oncological, and functional outcomes.
METHODS: This was a single-center, single-surgeon study analyzing patients who underwent open versus robotic intracorporeal neobladder (RIN) from January 2009 to January 2020. We recorded baseline characteristics, perioperative variables, outcomes, including cancer-specific survival (CSS) and overall survival (OS), and functional outcomes.
RESULTS: The study included 454 patients (242 open, 212 robotic) with an overall follow-up of 120 months. The RIN group had significantly lower blood loss (p < 0.001), more unilateral nerve sparing (p = 0.008), and higher lymph node yield (p = 0.042). The number of 30-day readmissions favored RIN significantly (p = 0.041). Complication rates (major and minor) were similar between groups (p = 0.56 and 0.61, respectively). The RIN group had improved severe daytime continence (p = 0.03), though no significant difference was found in erectile function (p = 0.56). The robotic cohort showed improved 10-year CSS in T3 disease (68.3% vs. 50.5%, p = 0.04). The OS for the entire cohort was 66.5% for the robotic cohort and 61.6% for open at 10 years (p = 0.08).
CONCLUSIONS: In this series, RIN had decreased blood loss, an increased lymph node yield, decreased rate of hospital readmissions, lesser hospital stay, and improved severe daytime continence compared to the open approach.
METHODS: This was a single-center, single-surgeon study analyzing patients who underwent open versus robotic intracorporeal neobladder (RIN) from January 2009 to January 2020. We recorded baseline characteristics, perioperative variables, outcomes, including cancer-specific survival (CSS) and overall survival (OS), and functional outcomes.
RESULTS: The study included 454 patients (242 open, 212 robotic) with an overall follow-up of 120 months. The RIN group had significantly lower blood loss (p < 0.001), more unilateral nerve sparing (p = 0.008), and higher lymph node yield (p = 0.042). The number of 30-day readmissions favored RIN significantly (p = 0.041). Complication rates (major and minor) were similar between groups (p = 0.56 and 0.61, respectively). The RIN group had improved severe daytime continence (p = 0.03), though no significant difference was found in erectile function (p = 0.56). The robotic cohort showed improved 10-year CSS in T3 disease (68.3% vs. 50.5%, p = 0.04). The OS for the entire cohort was 66.5% for the robotic cohort and 61.6% for open at 10 years (p = 0.08).
CONCLUSIONS: In this series, RIN had decreased blood loss, an increased lymph node yield, decreased rate of hospital readmissions, lesser hospital stay, and improved severe daytime continence compared to the open approach.