Email this article 
Analysis of the experience of robot-assisted cystectomy with various types of urine derivation
- Authors: Monakov D.M.1,2, Savin L.T.1, Kochetov A.G.3, Karelskaya N.A.1, Dmitrieva T.A.1, Oganyan V.A.1, Magomedov R.N.1, Gritskevich A.A.1,2
-
Affiliations:
- A.V. Vishnevsky National Medical Research Center of Surgery
- People’s Friendship University of Russia
- National Medical Research Center for High Medical Technologies — A.A. Vishnevsky Central Military Clinical Hospital
- Issue: Vol 14, No 2 (2024)
- Pages: 129-138
- Section: Original articles
- URL: https://journals.eco-vector.com/uroved/article/view/632838
- DOI: https://doi.org/10.17816/uroved632838
- ID: 632838
Cite item
Open Access
Access granted
Subscription or Fee Access
Abstract
BACKGROUND: Radical cystectomy is the main treatment for patients with muscle-invasive bladder cancer. Robot-assisted operations have become increasingly widespread; thus, an analysis of the results of using this technique is required.
AIM: To analyze our experience with robot-assisted radical cystectomy with different types of urinary diversion and compare the results to those obtained by other centers.
MATERIALS AND METHODS: The treatment results of 23 patients who underwent robot-assisted cystectomy with various types of urine derivation for bladder cancer between 2021 and 2024 were retrospectively analyzed.
RESULTS: Patients who had the Studer urinary reservoir formed were slightly younger and had better functional status and a higher body mass index. Additionally, there were more patients of the very high-risk cT1 stage. In patients who underwent ureterocutaneostomy, stages sT3–4 were more common. The average duration of the operation was 418.2 minutes. The longest duration (533.5 minutes) was observed during the formation of the urinary reservoir and the shortest (294.3 minutes) during ureterocutaneostomy. The smallest (200 ml) and largest (3,500 ml) blood loss occurred in patients who underwent Bricker ileal conduit formation. Ten conversions to open surgery (5 in the group of patients who had a urinary reservoir and 5 in ileoconduit) were noted. Nine patients developed postoperative complications, with seven exhibiting Clavien–Dindo grade IIIa–IIIb complications. The median follow-up was 19.7 months. Disease progression occurred in two (9%) patients. One patient died 1.5 years after surgery due to underlying disease progression.
CONCLUSIONS: Robot-assisted cystectomy is currently limited to specialized centers. The exchange of experience between them and its analysis are crucial to assess the immediate and long-term results of this technique and determine the category of patients who will benefit most from its application.
About the authors
Dmitry M. Monakov
A.V. Vishnevsky National Medical Research Center of Surgery; People’s Friendship University of Russia
Author for correspondence.
Email: gvkg-monakov@mail.ru
ORCID iD: 0000-0002-9676-1802
SPIN-code: 2432-3491
Scopus Author ID: 57221944805
MD, Cand. Sci. (Medicine)
Russian Federation, Moscow; MoscowLeonid T. Savin
A.V. Vishnevsky National Medical Research Center of Surgery
Email: savleons@gmail.ru
SPIN-code: 6546-6923
MD
Russian Federation, MoscowAleksandr G. Kochetov
National Medical Research Center for High Medical Technologies — A.A. Vishnevsky Central Military Clinical Hospital
Email: dr.alexandr68@yandex.ru
ORCID iD: 0000-0003-3151-5181
SPIN-code: 4499-5642
MD, Dr. Sci. (Medicine)
Russian Federation, Krasnogorsk, Moscow RegionNatalia A. Karelskaya
A.V. Vishnevsky National Medical Research Center of Surgery
Email: karelskaya.n@yandex.ru
ORCID iD: 0000-0001-8723-8916
SPIN-code: 9921-1430
MD, Cand. Sci. (Medicine)
Russian Federation, MoscowTata A. Dmitrieva
A.V. Vishnevsky National Medical Research Center of Surgery
Email: dmitrieva_tataaleksandrovna@mail.ru
ORCID iD: 0009-0006-4992-5487
MD
Russian Federation, MoscowVardan A. Oganyan
A.V. Vishnevsky National Medical Research Center of Surgery
Email: vardan_94@mail.ru
ORCID iD: 0000-0002-2059-8703
SPIN-code: 5557-4363
MD
Russian Federation, MoscowRadzhab N. Magomedov
A.V. Vishnevsky National Medical Research Center of Surgery
Email: radjab.magomedov95@mail.ru
MD
Russian Federation, MoscowAleksandr A. Gritskevich
A.V. Vishnevsky National Medical Research Center of Surgery; People’s Friendship University of Russia
Email: grekaa@mail.ru
ORCID iD: 0000-0002-5160-925X
SPIN-code: 2128-7536
Scopus Author ID: 57194755867
MD, Dr. Sci. (Medicine)
Russian Federation, Moscow; MoscowReferences
- Lobo N, Afferi L, Moschini M, et al. Epidemiology, screening, and prevention of bladder cancer. Eur Urol Oncol. 2022;5(6):628–639. doi: 10.1016/j.euo.2022.10.003
- Kaprin AD, Starinsky BB, Shakhzadova AO, editors. The state of oncological care for the Russian population in 2022. Moscow: Publishing house of the P.A. Herzen Research Institute of Oncology — a branch of the Federal State Budget Institution “NMC Radiology” of the Ministry of Health of Russia; 2022. 239 p. (In Russ.)
- LLC “Russian Society of Oncourologists”, Association of Oncologists of Russia, LLC “Russian Society of Urologists”, LLC “Russian Society of Clinical Oncology”. Bladder cancer. Clinical recommendations. Moscow; 2023. 125 p. (In Russ.)
- Witjes JA, Bruins MH, Carrión A, et al. European Association of Urology guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2023 Guidelines. Eur Urol. 2024;85(1):17–31. doi: 10.1016/j.eururo.2023.08.016
- Cai PY, Khan AI, Shoag JE, Scherr DS. Robotic radical cystectomy in the contemporary management of bladder cancer. Urol Clin North Am. 2021;48(1):45–50. doi: 10.1016/j.ucl.2020.09.003
- Binet A, Ballouhey Q, Chaussy Y, et al. Current perspectives in robot-assisted surgery. Minerva Pediatr. 2018;70(3):308–314. doi: 10.23736/S0026-4946.18.05113-7
- Attalla K, Kent M, Waingankar N, Mehrazin R. Robotic-assisted radical cystectomy versus open radical cystectomy for management of bladder cancer: review of literature and randomized trials. Future Oncol. 2017;13(13):1195–1204. doi: 10.2217/fon-2017-0004
- Bochner BH, Dalbagni G, Marzouk KH, et al. Randomized trial comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: oncologic outcomes. Eur Urol. 2018;74(4): 465–471. doi: 10.1016/j.eururo.2018.04.030
- Satkunasivam R, Tallman CT, Taylor JM, et al. Robot-assisted radical cystectomy versus open radical cystectomy: A meta-analysis of oncologic, perioperative, and complication-related outcomes. Eur Urol Oncol. 2019;2(4):443–447. doi: 10.1016/j.euo.2018.10.008.
- Lakhno DA, Zingerenko MB, Gazaryan MA, Khatkov IE. Radical robot-assisted cystectomy: experience of the first 20 operations. Endoscopic surgery. 2018;24(6):3–10. EDN: YXCZPV doi: 10.17116/endoskop2018240613
- Guliev BG, Bolokotov RR. Robot-assisted and open radical cystectomy: comparative analysis of results. Urology Herald. 2020;8(1): 59–68. EDN: YUAOXE doi: 10.21886/2308-6424-2020-8-1-59-68
- Pavlov VN, Urmantsev MF, Bakeev MR. The success of robot-assisted cystectomy in the treatment of muscle-invasive bladder cancer. Cancer Urology. 2022;18(2):123–128. EDN: UDBPJD doi: 10.17650/1726-9776-2022-18-2-123-128
Supplementary files
