Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes

Abstract

BackgroundThis study compared the surgical and urinary functional outcomes in patients with muscle‐invasive bladder cancer (MIBC) who underwent robot‐assisted radical cystectomy (RARC) followed by intracorporeal ileal neobladder reconstruction (ICNB) to those in patients who underwent minimum incision endoscopic radical cystectomy (MIE‐RC) followed by extracorporeal ileal neobladder reconstruction (ECNB).Materials and MethodsThis study reviewed the clinical records of 153 consecutive MIBC patients who underwent neoadjuvant chemotherapy followed by radical cystectomy and ileal neobladder reconstruction.ResultsThe operative time in the ICNB group was significantly longer than that in the ECNB group. The median estimated blood loss was significantly less in the ICNB group than in the ECNB group. The neobladder capacity gradually increased in both groups. The maximum neobladder pressure and urethral closure pressure gradually improved in both groups.ConclusionOur initial experience with ICNB was favourable, with acceptable surgical and urinary functional outcomes.

Utility of robot‐assisted radical cystectomy with intracorporeal urinary diversion for muscle‐invasive bladder cancer

“…Several steps have been shown to have a causative role in postoperative ileus. However, there were no statistically significant differences in the major complications between the two groups (Table ) . In addition, the rate of postoperative ileus was not high in our series .…”

“…However, there were no statistically significant differences in the major complications between the two groups (Table ) . In addition, the rate of postoperative ileus was not high in our series . Indeed, totally ICUD technique increased the complexity of the procedure.…”

“…). The operative time in the ICNB group was significantly longer than in the ECNB group . The median EBL was less and the transfusion rate was significantly lower in the ICNB group than in the ECNB group ( P < 0.001) .…”

“…However, ICUD might have potential benefits, including decreased fluid loss, reduced EBL and a quicker return of bowel function . The adoption of ICNB has hitherto been limited to high‐volume academic institutions, and several surgical techniques for ICNB have been reported with promising functional outcomes …”

“…12 The adoption of ICNB has hitherto been limited to high-volume academic institutions, and several surgical techniques for ICNB have been reported with promising functional outcomes. 4,[13][14][15][16][17][18] In the present review, we compare the totally intracorporeal RARC approach with ORC and RARC + ECUD in MIBC patients, focusing on perioperative morbidities and oncological outcomes.…”