Systematic review of robotic radical cystectomy functional and quality of life outcomes

Jue, Joshua S.; Mikhail, David; Feuerstein, Michael

doi:10.5489/cuaj.7313

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Our initial review also demonstrated that surgical approach for radical cystectomy did not have a significant impact on patient-important outcomes [ 9 ]. The results from other systematic reviews that also included non-randomised studies were consistent with these findings [ 23 , 24 ]. Therefore, both RARC and ORC can be considered to be equivalent in the wider sense with the decision on approach based on surgeon experience/training, accessibility and health economics.…”

Section: Discussionsupporting

confidence: 81%

Comparison of Robotic vs Open Cystectomy: A Systematic Review

Sathianathen,

Pan,

Furrer

et al. 2023

Bladder Cancer

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BACKGROUND: The benefits of a robot-assisted radical cystectomy (RARC) compared to an open approach is still under debate. Initial data on RARC were from trials where urinary diversion was performed by an extracorporeal approach, which does not represent a completely minimally invasive procedure. There are now updated data for RARC with intracorporeal urinary diversion that add to the evidence profile of RARC. OBJECTIVE: To perform a systematic review and meta-analysis of the effectiveness of RARC compared with open radical cystectomy (ORC). MATERIALS AND METHODS: Multiple databases were searched up to May 2022. We included randomised trials in which patients underwent RARC and ORC. Oncological and safety outcomes were assessed. RESULTS: Seven trials of 907 participants were included. There were no differences seen in primary outcomes: disease progression [RR 0.98, 95% CI 0.78 to 1.23], major complications [RR 0.95, 95% CI 0.72 to 1.24] and quality of life [SMD 0.05, 95% CI -0.13 to 0.38]. RARC resulted in a decreased risk of perioperative blood transfusion [RR 0.57, 95% CI 0.43 to 0.76], wound complications [RR 0.34, 95% CI 0.21 to 0.55] and reduced length of hospital stay [MD -0.62 days, 95% CI -1.11 to -0.13]. However, there was an increased risk of developing a ureteric stricture [RR 4.21, 95% CI 1.07 to 16.53] in the RARC group and a prolonged operative time [MD 70.4 minutes, 95% CI 34.1 to 106.7]. The approach for urinary diversion did not impact outcomes. CONCLUSION: RARC is an oncologically safe procedure compared to ORC and provides the benefits of a minimally invasive approach. There was an increased risk of developing a ureteric stricture in patients undergoing RARC that warrants further investigation. There was no difference in oncological outcomes between approaches.

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Section: Discussionsupporting

confidence: 81%

Comparison of Robotic vs Open Cystectomy: A Systematic Review

Sathianathen,

Pan,

Furrer

et al. 2023

Bladder Cancer

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“…summarized that the QoL outcomes were similar between RARC and ORC. 46 Fuschi et al. revealed that the rates of complications of intracorporeal UD were 37.4% of single stoma ureterocutaneostomy and 57.6% of IC.…”

Section: Discussionmentioning

confidence: 99%

“…45 Jue et al summarized that the QoL outcomes were similar between RARC and ORC. 46 Fuschi et al revealed that the rates of complications of intracorporeal UD were 37.4% of single stoma ureterocutaneostomy and 57.6% of IC. 47 In our study, all patients underwent laparoscopic RC plus extracorporeal UD and the rate of late complication was 42.9% (MSSCU) and 43.5% (IC), which was nearly consistent with previous study.…”

Section: T a B L Ementioning

confidence: 99%

The effect of body mass index on quality of life in modified single stoma cutaneous ureterostomy or ileal conduit after radical cystectomy

Zhang,

Huang,

Lin

et al. 2023

Cancer Medicine

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ObjectiveTo explore the influence of postoperative body mass index (BMI) change on postoperative quality of life (QOL) in patients undergoing radical cystectomy (RC) plus modified single stoma cutaneous ureterostomy (MSSCU) or ileal conduit (IC).MethodsPatients were divided into two groups according to different BMI change patterns: patients experiencing an elevated postoperative BMI level, along with a clinically significant increase in their BMI (an increase of more than 10%) were categorized as Group 1, while patients experiencing a decrease postoperative BMI level, along with a clinically significant reduction in their BMI (a decrease of more than 5%) were categorized as Group 2. Spearman correlation analysis was used to examine the correlations between quality‐of‐life scores and postoperative clinical parameters.ResultsSpearman correlation analysis showed that postoperative BMI, late complications and catheter‐free state were significantly associated with postoperative global QoL and symptom scale in MSSCU and postoperative global QoL and physical scale in IC patients. Additionally, postoperative BMI, catheter‐free state and the use of adjuvant therapy were associated with bad performance in many scales of QoL like body image, future perspective, social scale, future perspective (MSSCU), and abdominal bloating (IC) (Table 2, p<0.05). Patients in Group 2 with significant weight loss had a better Global QoL, a lower rate of stomal stricture and a higher catheter‐free state compared with those in Group 1 in both IC and MSSCU patients. MSSCU patients in Group 2 could achieve a comparable Global QoL as to IC patients in Group 1.ConclusionControlling the substantial increase in body weight after surgery contributes to improving QoL, reducing the occurrence of stomal stricture, and ensuring a postoperative catheter‐free state in BCa patients undergoing MSSCU.

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“…Robotic-assisted laparoscopic radical cystectomy (RARC) was introduced in 2003. Although its use has rapidly increased, randomized controlled trials have shown similar perioperative outcomes and complication rates between traditional open radical cystectomy (ORC) and RARC methods [ 51 ].…”

Section: Introductionmentioning

confidence: 99%

“…The potency rates after RC range between 14% and 80% and are comparable between ORC and RARC series [ 19 , 49 , 51 ]. Nerve-sparing techniques preserve the autonomic nerves involved in erectile function, improving potency compared to standard RC [ 6 , 50 , 51 ] without compromising oncological outcomes. Rates of post-RC ED are estimated to be 10–30% after NS techniques and 80–90% following the use of standard technique [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction in Pelvic Cancer Survivors and Current Management Options

Bernal

Venkatesan

Martins

2023

JCM

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Pelvic malignancies, including prostate, rectal, and bladder cancers, are among the most frequent malignancies found in the male population. These issues are most effectively and commonly treated with radiotherapy and/or surgery. However, these treatments can cause collateral damage, resulting in significant impacts on quality of life, with erectile dysfunction being one of the most frequent postoperative complications. Currently, there are several treatment options for erectile dysfunction, including oral phosphodiesterase type 5 inhibitors, vacuum erection devices, intracorporeal injections, and penile prosthesis. The latter has shown to be an effective and safe technique, with results comparable to those obtained by patients without pelvic surgery or radiotherapy. The results of early penile rehabilitation programs are promising and they have been incorporated into a greater proportion of treatment plans more recently, with varying degrees of success. In this narrative review, we summarize the literature on erectile dysfunction after pelvic cancer treatments and its management.

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Systematic review of robotic radical cystectomy functional and quality of life outcomes

Cited by 5 publications

References 27 publications

Comparison of Robotic vs Open Cystectomy: A Systematic Review

Comparison of Robotic vs Open Cystectomy: A Systematic Review

The effect of body mass index on quality of life in modified single stoma cutaneous ureterostomy or ileal conduit after radical cystectomy

Erectile Dysfunction in Pelvic Cancer Survivors and Current Management Options

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