Patel Hitendra R H, Santos Pedro Bargão, de Oliveira Manuel Castanheira, Müller Stig
Department of Urology, University Hospital North Norway (UNN), Tromsö, Norway.
Department of Urology, Hospital CUF Descobertas, Lisbon, Portugal.
World J Urol. 2016 Jan;34(1):25-32. doi: 10.1007/s00345-015-1730-1. Epub 2015 Nov 25.
Totally intracorporeal robotic-assisted radical cystectomy (RARC) has perceived difficulties compared to open radical cystectomy (ORC). As the technique is increasingly adopted around the world, the benefits of RARC with intra- or extracorporeal urinary diversion or ORC for the patients are still unclear. In this article, we consider the current evidence for this issue.
We assessed two questions through using expert opinion and the medical literature: (A) Is RARC better than ORC for removing the cancer surgery and outcome? (B) Is RARC better than ORC for the urinary diversion?
(A) RARC is better than ORC for shorter length of stay, blood loss and complication rates. (B) Intracorporeal orthotopic neobladder may have a significant physiological and surgical benefit to the patient recovery.
RARC with total intracorporeal reconstruction has potential benefits to the patient. We recommend that all surgeons document patient-related outcome measures, urodynamics and enhanced recovery protocols for cystectomy patients to help us understand the real improvements within bladder cancer surgery and reconstruction.
与开放性根治性膀胱切除术（ORC）相比，完全腹腔镜下机器人辅助根治性膀胱切除术（RARC）存在一些已知的困难。随着该技术在全球范围内越来越多地被采用，RARC联合体内或体外尿流改道术与ORC相比对患者的益处仍不明确。在本文中，我们探讨了关于这个问题的现有证据。
我们通过专家意见和医学文献评估了两个问题：（A）在癌症手术切除及预后方面，RARC是否优于ORC？（B）在尿流改道术方面，RARC是否优于ORC？
（A）RARC在缩短住院时间、减少失血量和降低并发症发生率方面优于ORC。（B）体内原位新膀胱术可能对患者恢复具有显著的生理和手术益处。
完全腹腔镜下重建的RARC对患者具有潜在益处。我们建议所有外科医生记录膀胱切除术患者的相关预后指标、尿动力学检查结果以及强化康复方案，以帮助我们了解膀胱癌手术和重建过程中的实际改善情况。
