Year : 2018 | Volume
: 34 | Issue : 2 | Page : 122--126
Robot-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: Initial experience and outcomes
Nitin Shrivastava, Brusabhanu Nayak, Premnath Dogra, Rajeev Kumar, Prabhjot Singh
Department of Urology, AIIMS, New Delhi, India
Introduction: Open radical cystectomy (ORC) is the most common surgical approach for invasive carcinoma of the urinary bladder, but robot-assisted radical cystectomy (RARC) has recently gained popularity. There is limited data from the Indian subcontinent on RARC . The aim of this study was to assess the perioperative, pathological, and oncological outcomes of RARC and follow-up in our initial 63 cases.
Materials and Methods: A retrospective analysis of prospectively maintained data of 63 RARC procedures performed in our tertiary care institute from July 2006 to January 2016 was done. All patients underwent RARC with extracorporeal urinary diversion. We analyzed perioperative parameters, length of hospital stay, pathological and oncological outcomes, and rate of complications. Follow-up data were analyzed for disease recurrence and survival.
Results: The mean age of the patients was 58 years. The mean American Society of Anesthesiologists (ASA) score was 1.66. Mean operative time was 348.6 min and mean blood loss was 868.2 ml. Mean hospital stay was 10.4 days (±5.4 days). 42.8% patients had pT2 disease, 49.2% pT3, 1.58% pT1, and 6.34% had pT4 disease. Mean lymph node yield was 12.4 (3-25). One patient had positive surgical margins. Twenty-four patients had postoperative complications of which four were major complications (Clavien-Dindo 3 or higher). At a median follow-up of 60 months (range: 3–108 months), 11 patients were lost to follow-up 10 patients developed metastasis, out of which 4 died. Four had recurrence, two died and two are receiving chemotherapy.
Conclusion: This study shows the feasibility and safety of RARC. The operative time, blood loss, return of bowel activity and hospital stay were higher than those reported in the literature but may reflect the learning curve.
Department of Urology, AIIMS, New Delhi
|How to cite this article:|
Shrivastava N, Nayak B, Dogra P, Kumar R, Singh P. Robot-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: Initial experience and outcomes.Indian J Urol 2018;34:122-126
|How to cite this URL:|
Shrivastava N, Nayak B, Dogra P, Kumar R, Singh P. Robot-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: Initial experience and outcomes. Indian J Urol [serial online] 2018 [cited 2021 Sep 19 ];34:122-126
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2018;volume=34;issue=2;spage=122;epage=126;aulast=Shrivastava;type=0