It can be performed by an open or minimally invasive approach (laparoscopic and robot-assisted radical cystectomy). Introduction Urothelial cell carcinoma is the most common neoplasm of the genito-urinary tract, which, in advanced stages, is treated with radical cystectomy with pelvic lymphadenectomy. Juszczak, Kajetan Poblocki, Pawel Mikolajczak, Witold Drewa, Tomasz Robot-assisted radical cystectomy – first Polish clinical outcomes The experience of only 50 robot-assisted radical prostatectomies is a minimum requirement for performing feasible robot-assisted radical cystectomy, and surgeons who have performed only 30 surgeries can reach an acceptable level of quality for robot-assisted radical cystectomy. A steep learning curve is one of the benefits of the new technique. Further validation is necessary to prove the feasibility of oncological control. However, the recurrence pattern is different between robot-assisted radical cystectomy and open radical cystectomy, i.e., extrapelvic lymph node recurrence and peritoneal carcinomatosis were more frequently found in patients who underwent robot-assisted radical cystectomy than in those who underwent open radical cystectomy. The survival rates after robot-assisted radical cystectomy are estimated to be similar to that after open radical cystectomy. The lymph node yield and positive surgical margin rate were not significantly different between robot-assisted radical cystectomy and open radical cystectomy. Accordingly, robot-assisted radical cystectomy can be performed safely with an acceptable operative time, little blood loss, and low transfusion rates. Urinary diversion is performed either extracorporeally with a small skin incision or intracorporeally with a totally robotic-assisted maneuver. Relative contraindications are due to patient positioning in the Trendelenburg position for long periods. The indications for robot-assisted radical cystectomy are identical to those of open radical cystectomy. We compared the surgical technique, perioperative and oncological outcomes, and learning curve of robot-assisted radical cystectomy with those of open radical cystectomy. In recent years, robot-assisted radical cystectomy has received attention worldwide as a useful procedure that helps to overcome the limitations of open radical cystectomy. When significant experience in laparoscopic surgery is lacking, surgeons should exercise caution with completely intracorporeal urinary diversion.Ĭurrent Status of Robot-Assisted Radical Cystectomy: What is the Real Benefit? On short-term, the results of laparoscopic radical cystectomy are encouraging. The resection margins of the surgical specimens were tumor free at pathologic examination. LRC has a longer operative time but with statistically significant lower blood loss, less analgesia, and shorter hospital stay. B) in term of: operative time, blood loss, analgesic requirements, and hospital stay. These patients were compared with a retrospective group of 50 patients who underwent open procedure (Gr. Since May 2004 were performed 7 LRC (5 males and 2 females) (Gr. The aim of our study is to present the first series of LRC with ureterosigmoidostomy. Even if laparoscopic radical cystectomy (LRC) is a well established surgical procedure, performing the urinary diversion completely intracorporeal, is still a challenge due to technical difficulties and associated complications. Radical cystectomy is the standard therapy for invasive bladder cancer, with best oncological results compared to any other therapeutic alternative. Lucan, M Iacob, G Lucan, V Măgurean, O Elec, F Burghelea, C Bărbos, A
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |