Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence
Radical cystectomy represents one of the most challenging surgical procedures, exhibiting a high morbidity rate. The transition to minimally invasive surgery in the field has been steep, due to either the technical complexity and prior concerns of atypical recurrences and/or peritoneal spread. More...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
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| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/4/714 |
| _version_ | 1827757931459772416 |
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| author | Bernardo Rocco Giulia Garelli Simone Assumma Filippo Turri Mattia Sangalli Tommaso Calcagnile Giorgia Gaia Stefano Terzoni Guglielmo Oliviero Daniele Stroppa Enrico Panio Luca Sarchi Alberto del Nero Giorgio Bozzini Angelica Grasso Paolo Dell’Orto Maria Chiara Sighinolfi |
| author_facet | Bernardo Rocco Giulia Garelli Simone Assumma Filippo Turri Mattia Sangalli Tommaso Calcagnile Giorgia Gaia Stefano Terzoni Guglielmo Oliviero Daniele Stroppa Enrico Panio Luca Sarchi Alberto del Nero Giorgio Bozzini Angelica Grasso Paolo Dell’Orto Maria Chiara Sighinolfi |
| author_sort | Bernardo Rocco |
| collection | DOAJ |
| description | Radical cystectomy represents one of the most challenging surgical procedures, exhibiting a high morbidity rate. The transition to minimally invasive surgery in the field has been steep, due to either the technical complexity and prior concerns of atypical recurrences and/or peritoneal spread. More recently, a larger series of RCTs has proven the oncological safety of robot-assisted radical cystectomy (RARC). Beyond survival outcomes, the comparison between RARC and open surgery in terms of peri-operative morbidity is still ongoing. We present a single-center experience of RARC with intracorporeal urinary diversion. Overall, 50% of patients had an intracorporeal neobladder reconstruction. The series confirms a low rate of complications (Clavien Dindo ≥ IIIa 7.5%) and wound infections (2.5%) and the absence of thromboembolic events. No atypical recurrences were found. To discuss these outcomes, we reviewed the literature related to RARC including level-1 evidence. PubMed and Web of Science searches were performed using the medical subject terms “robotic radical cystectomy” and “randomized controlled trial (RCT)”. Six unique RCTs comparing robot and open surgery were found. Two clinical trials dealt with RARC with an intracorporeal reconstruction of UD. Pertinent clinical outcomes are summarized and discussed. In conclusion, RARC is a complex but feasible procedure. The transition from extracorporeal urinary diversion (UD) to a complete intracorporeal reconstruction could be the key to improving peri-operative outcomes and reducing the whole morbidity of the procedure. |
| first_indexed | 2024-03-11T08:57:27Z |
| format | Article |
| id | doaj.art-ebae12d93b1843f29cf9e740cb5344fb |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T08:57:27Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-ebae12d93b1843f29cf9e740cb5344fb2023-11-16T20:01:56ZengMDPI AGDiagnostics2075-44182023-02-0113471410.3390/diagnostics13040714Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent EvidenceBernardo Rocco0Giulia Garelli1Simone Assumma2Filippo Turri3Mattia Sangalli4Tommaso Calcagnile5Giorgia Gaia6Stefano Terzoni7Guglielmo Oliviero8Daniele Stroppa9Enrico Panio10Luca Sarchi11Alberto del Nero12Giorgio Bozzini13Angelica Grasso14Paolo Dell’Orto15Maria Chiara Sighinolfi16Department of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyDepartment of Urology, ASST Santi Paolo and Carlo, La Statale University of Milan, 20142 Milano, ItalyRadical cystectomy represents one of the most challenging surgical procedures, exhibiting a high morbidity rate. The transition to minimally invasive surgery in the field has been steep, due to either the technical complexity and prior concerns of atypical recurrences and/or peritoneal spread. More recently, a larger series of RCTs has proven the oncological safety of robot-assisted radical cystectomy (RARC). Beyond survival outcomes, the comparison between RARC and open surgery in terms of peri-operative morbidity is still ongoing. We present a single-center experience of RARC with intracorporeal urinary diversion. Overall, 50% of patients had an intracorporeal neobladder reconstruction. The series confirms a low rate of complications (Clavien Dindo ≥ IIIa 7.5%) and wound infections (2.5%) and the absence of thromboembolic events. No atypical recurrences were found. To discuss these outcomes, we reviewed the literature related to RARC including level-1 evidence. PubMed and Web of Science searches were performed using the medical subject terms “robotic radical cystectomy” and “randomized controlled trial (RCT)”. Six unique RCTs comparing robot and open surgery were found. Two clinical trials dealt with RARC with an intracorporeal reconstruction of UD. Pertinent clinical outcomes are summarized and discussed. In conclusion, RARC is a complex but feasible procedure. The transition from extracorporeal urinary diversion (UD) to a complete intracorporeal reconstruction could be the key to improving peri-operative outcomes and reducing the whole morbidity of the procedure.https://www.mdpi.com/2075-4418/13/4/714radical cystectomyrobotic surgeryintracorporeal urinary diversionmorbidity |
| spellingShingle | Bernardo Rocco Giulia Garelli Simone Assumma Filippo Turri Mattia Sangalli Tommaso Calcagnile Giorgia Gaia Stefano Terzoni Guglielmo Oliviero Daniele Stroppa Enrico Panio Luca Sarchi Alberto del Nero Giorgio Bozzini Angelica Grasso Paolo Dell’Orto Maria Chiara Sighinolfi Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence Diagnostics radical cystectomy robotic surgery intracorporeal urinary diversion morbidity |
| title | Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence |
| title_full | Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence |
| title_fullStr | Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence |
| title_full_unstemmed | Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence |
| title_short | Robot-Assisted Radical Cystectomy: A Single-Center Experience and a Narrative Review of Recent Evidence |
| title_sort | robot assisted radical cystectomy a single center experience and a narrative review of recent evidence |
| topic | radical cystectomy robotic surgery intracorporeal urinary diversion morbidity |
| url | https://www.mdpi.com/2075-4418/13/4/714 |
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