Robot-Assisted Cystectomy and Ileal Conduit for Neurogenic Bladder: Comparison of Extracorporeal <i>vs</i> Intracorporeal Urinary Diversion

Mazouin, C.; Hubert, Jacques; Tricard, Thibault; Lecoanet, Pierre; Haudebert, C.; Bentellis, I.; Baron, Pierre; Hascoët, J.; Castes, Camille; Verhoest, G.; Tibi, B.; Pradère, Benjamin; Bruyère, F.; Capon, G.; Manunta, A.; Saussine, C.; Peyronnet, B.

doi:10.1089/end.2020.0921

Cited by 7 publications

(6 citation statements)

References 24 publications

(22 reference statements)

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“…The main underlying neurological diseases were multiple sclerosis ( n = 70, 50%) and spinal cord injury ( n = 37, 26,4%). The median duration of disease progression at the time of surgery was 18 years 8–25 . The main preoperative bladder management was indwelling catheter ( n = 76, 54%).…”

Section: Resultsmentioning

confidence: 99%

“…Although we did not demonstrate an association between a higher BMI and a higher rate of ureteroileal strictures, obesity can likely lead to excessive traction on the ureters at the time of Wallace anastomosis with the risk of devascularization, especially when this anastomosis is performed extracorporeally. In these patients, a robotic approach with intracorporeal realization of the ileal conduit might be of great interest 22 . However, regardless of the approach, minimal dissection of the ureters is recommended, to avoid problems with devascularization 6 …”

Section: Discussionmentioning

confidence: 99%

“…The median duration of disease progression at the time of surgery was 18 years. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] The main preoperative bladder management was indwelling catheter (n = 76, 54%). The main indication for the surgery was the inability to perform ISC (n = 125, 89%) either related to cognitive impairment and/or to upper limb disability (n = 117, 84%).…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Robot‐assisted laparoscopic cystectomy with non‐continent urinary diversion for neurogenic lower urinary tract dysfunction: Midterm outcomes

Calën

Mesnard

Hedhli

et al. 2023

Neurourology and Urodynamics

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The aim of this study was to assess midterm functional outcomes and complications of robot-assisted laparoscopic cystectomy with non-continent urinary diversion in patients with neurogenic lower urinary tract dysfunction. Materials and Methods: We performed a retrospective single center study including all patients who underwent robot-assisted laparoscopic cystectomy with non-continent urinary diversion between January 2008 and December 2018 for neurogenic lower urinary tract dysfunction. Perioperative data, early and late complications, reoperation rate, renal function, and patient satisfaction (PGI-I) were evaluated.Results: One hundred and forty patients were included (70 multiple sclerosis, 37 spinal cord injuries, 33 others) with a median follow-up of 29 months (12−49). The main indication for surgery was an inability to perform intermittent self-catheterization (n = 125, 89%). The early complication rate (<30 days) was 41% (n = 58), including 72% (n = 45) minor complications (Clavien I−II) and 29% (n = 17) major complications (Clavien III−V). Three patients died in the early postoperative period.Late complications appear in 41% (n = 57), with 9% (n = 13) being ureteroileal anastomotic stricture. The overall reintervention rate was 19% (n = 27), mainly for lithiasis surgery. Pre-and postoperative renal function were comparable. Most of patients reported an improvement in their quality of life following their surgery (PGI-I 1−2). Conclusion:Robot-assisted laparoscopic cystectomy with non-continent urinary diversion may be of particular interest in patients with neurogenic

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patient Characteristicsmentioning

confidence: 99%

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Robot‐assisted laparoscopic cystectomy with non‐continent urinary diversion for neurogenic lower urinary tract dysfunction: Midterm outcomes

Calën

Mesnard

Hedhli

et al. 2023

Neurourology and Urodynamics

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“…However, a recent series comparing these two approaches suggested that they may have only negligible differences in terms of perioperative outcomes. 26…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the robotic group could be regarded as heterogeneous as it included both intracorporeal and extracorporeal urinary diversion. However, a recent series comparing these two approaches suggested that they may have only negligible differences in terms of perioperative outcomes 26 …”

Section: Discussionmentioning

confidence: 99%

Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robotic approaches

Haudebert

Hascoët

Freton

et al. 2021

Neurourology and Urodynamics

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Aim:The objective of the present study was to compare the outcomes of open versus laparoscopic versus robotic cystectomy and ileal conduit for neurogenic lower urinary tract dysfunction (NLUTD). Methods: The charts of all patients who underwent cystectomy and ileal conduit for NLUTD between January 2004 and November 2020 in an academic center were retrospectively reviewed. The approach was either open, laparoscopic or robot-assisted depending on the period (i.e., three consecutive era).For the robotic approach, the diversion was done either intracorporeally or extracorporeally. We compared the perioperative and late postoperative outcomes between the three groups. Results: After exclusion of 10 patients with non-neurogenic benign conditions, 126 patients were included over the study period. The most frequent neurological conditions were multiple sclerosis (36.5%) and spinal cord injury (25.4%). The approach was open, laparoscopic or robot-assisted in 31 (24.6%), 26 (20.6%) and 69 (54.7%) cases respectively. Seventy-two patients experienced a 90-day postoperative complication (57.1%) of which 22 had a major complication (Clavien 3 or higher, 17.5%) including one death (0.8%). The rate of major postoperative complications was significantly lower in the robotic group (23% vs. 23% vs. 10%; p = 0.049) while the rate of overall complications was comparable across the three groups (58.1% vs. 53.9% vs. 60.6%; p = 0.84). After a median follow-up of 23 months, 22 patients presented a late complication (17.6%), mainly incisional hernia (5; 4%) and uretero-ileal stricture (9; 7.2%). The rate of late complications did not differ significantly between the three approaches. Conclusion:Cystectomy and ileal conduit for neurogenic bladder is associated with a relatively high perioperative morbidity. The robot-assisted approach may decrease the risk of major postoperative complications.

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Special surgical aspects of radical cystectomy in spinal cord injury patients with bladder cancer

et al. 2022

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Robot-Assisted Cystectomy and Ileal Conduit for Neurogenic Bladder: Comparison of Extracorporeal vs Intracorporeal Urinary Diversion

Cited by 7 publications

References 24 publications

Robot‐assisted laparoscopic cystectomy with non‐continent urinary diversion for neurogenic lower urinary tract dysfunction: Midterm outcomes

Robot‐assisted laparoscopic cystectomy with non‐continent urinary diversion for neurogenic lower urinary tract dysfunction: Midterm outcomes

Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robotic approaches

Special surgical aspects of radical cystectomy in spinal cord injury patients with bladder cancer

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