Department of Molecular Medicine and Surgery, Department of Pelvic Cancer, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden.
Department of Urology, University of Cincinnati, Cincinnati, OH, USA.
World J Urol. 2024 Nov 2;42(1):617. doi: 10.1007/s00345-024-05339-w.
To investigate functional, oncological and complication outcomes in women undergoing robot-assisted cystectomy (RARC) with intracorporeal orthotopic neobladder.
From a multi-institutional database, we identified females with bladder cancer treated with RARC and intracorporeal orthotopic neobladder. We evaluated the continence rate, short-term oncological outcomes, and complication rates. Analyses were repeated and stratified by the status of preserving gynecological organs.
The study involved 146 patients with the median age 60 years (IQR, 51-66 years). Pelvic organ-preserving procedure (POP) was performed in 77 patients (53%). Overall daytime and nighttime continence rates were 54% and 53%, respectively. For POP, the continence rate was 58% for both daytime and nighttime continence. In the non-POP cohort, the continence rate was 50% for daytime and 49% for nighttime continence. Both groups had balanced positive surgical margin rates (5,3% for POP and 4,7% for non-POP). In the whole cohort, high-grade (Clavien-Dindo ≥3) early and late complication rate was 7,5% and 7,5%, respectively.
Robot-assisted radical cystectomy with intracorporeal orthotopic neobladder in females demonstrate excellent functional and complication outcomes. Pelvic organ-preserving cystectomy enhances urinary continence rates without adversely affecting surgical margins. Orthotopic neobladder in selected women with bladder cancer, along with pelvic organ-preserving cystectomy may be used for improved functional outcomes without compromising oncological results.
研究接受机器人辅助膀胱切除术（RARC）联合体内原位新膀胱的女性的功能、肿瘤学和并发症结果。
我们从一个多机构数据库中确定了接受 RARC 和体内原位新膀胱治疗的膀胱癌女性患者。我们评估了控尿率、短期肿瘤学结果和并发症发生率。分析结果通过保留妇科器官的情况进行了重复和分层。
这项研究涉及 146 名中位年龄 60 岁（IQR，51-66 岁）的患者。在 77 名患者（53%）中进行了盆腔器官保留手术（POP）。总体日间和夜间控尿率分别为 54%和 53%。对于 POP，日间和夜间控尿率分别为 58%。在非 POP 队列中，日间控尿率为 50%，夜间控尿率为 49%。两组的阳性切缘率均平衡（POP 为 5%，非 POP 为 4.7%）。在整个队列中，早期和晚期高分级（Clavien-Dindo≥3）并发症发生率分别为 7.5%和 7.5%。
女性机器人辅助根治性膀胱切除术联合体内原位新膀胱具有出色的功能和并发症结果。盆腔器官保留性膀胱切除术可提高控尿率，而不会对手术切缘产生不利影响。在选择的膀胱癌女性中，使用原位新膀胱和盆腔器官保留性膀胱切除术可能会改善功能结果，而不会影响肿瘤学结果。
