Oncological and functional outcomes and complications of robotic intracorporeal Studer orthotopic neobladder: A single-center retrospective study.

BACKGROUND

Robotic intracorporeal Studer orthotopic neobladder (RISON) is a complex procedure for bladder reconstruction.

OBJECTIVE

This study aimed to retrospectively examine the oncological/functional outcomes, and complications of RISON at a single center.

METHODS

Baseline data and perioperative results of patients who received RISON between March 2018 and December 2022 were analyzed. Sixty-two cases (60 males, 2 females), with a mean age of 56.79 ± 9.12 years, were included in the study. Follow-up data regarding RISON's therapeutic effects, including tumor outcomes, neobladder capacity, continence, and complications, were collected.

RESULTS

All patients underwent the procedure without conversion to open surgery or changes in urinary diversion. The mean operative time lasted 379.2 ± 88.8 min, with a median blood loss of 200 mL (range: 100-300 mL). Indwelling time of the Ryles tube was 3.78 ± 2.23 days, and post-operative hospital stay was 10 days (range: 8-12 days). Pathological examination showed 87.1% (54/62) of cases had T2N0M0 tumors. A mean of 17.42 ± 8.03 lymph nodes were dissected, with three cases developing lymph node metastasis. Short-term complications (within 30 days) occurred in 51.9% of patients, while long-term complications (after 30 days) were found in 51.9% of patients. The mean neobladder volume measured 344.31 ± 147.00 mL. Daytime continence was achieved in 88.2% of patients, and night-time continence was attained in 39.2%. The average night-time urinary frequency was 2.78 ± 1.55 times, with 1.9 urine pads used on average. Follow-up duration ranged from 27 to 73 months, with a median time of 52.5 months. Five patients died of tumor metastasis, spreading to bone, liver, lung, brain, or lymph nodes. The 36- and 60-month cumulative recurrence-free survival rates were 96.3% and 87.4%, respectively. The 36- and 60-month cumulative overall survival rates were 96.3% and 90.4%, respectively.

CONCLUSION

Clinically, RISON is a safe and feasible procedure with excellent oncological and functional outcomes, showing promise for widespread application.