Peri- and postoperative outcomes of robot-assisted radical cystectomy (RARC)

Authors


Raj S. Pruthi, Division of Urologic Surgery, The University of North Carolina at Chapel Hill, 2113 Physicians Office Bldg CB 7235, 170 Manning Dr, Chapel Hill, NC 27599-7235, USA. e-mail: rpruthi@med.unc.edu

Abstract

What's known on the subject? and What does the study add?

Robot-assisted radical cystectomy is an increasingly used method for surgical extirpation for clinically localized, muscle-invasive urothelial cartinoma. This study reviews its technique and associated preoperative and oncological outcomes.

OBJECTIVE

  • • To assess peri-and postoperative outcomes of robot-assisted radical cystectomy (RARC) with pelvic lymph node dissection (PLND) and urinary diversion for the treatment of bladder cancer.

MATERIALS AND METHODS

  • • We review our previously described surgical technique for RARC and its development over recent years, with an accompanied video illustration.
  • • We also focus on peri- and postoperative outcomes of RARC and compare this with the ‘gold standard’ of open RC.

RESULTS

  • • RARC has been steadily growing since 2003, with acceptable peri-and postoperative outcomes.
  • • Most studies report decreased blood loss, return of bowel function, and shorter length of hospital stay. Furthermore, complication rates have been shown to be similar to that of open series.
  • • Most importantly, oncological outcomes appear to be favourable in terms of margin status, LND and disease-specific survival, although data may be affected by the lack of long-term results and a randomized clinical trial assessing overall survival.

CONCLUSIONS

  • • RARC with PLND and urinary diversion is an increasingly used strategy in the treatment armamentarium for bladder cancer.
  • • Perioperative and oncological outcomes from existing data have been favourable thus far, but are limited by relatively short follow-up.
  • • Randomized clinical trials with extended patient follow-up are needed to fully assess outcomes related to RARC.

Ancillary