Orthotopic neobladder reconstruction for bladder cancer : robotic-assisted versus open-radical cystectomy for perioperative outcomes, functional results and quality of life
Copyright © 2019 Elsevier Masson SAS. All rights reserved..
INTRODUCTION: Open radical cystectomy (ORC) is the gold standard technique for carcinologic cystectomies. Robotic-assisted radical cystectomy (RARC) was introduced in 2003 and its development is booming.
OBJECTIVE: To compare ORC and RARC with totally intracorporal (IC) orthotopic neobladder (ONB) reconstruction, in terms of perioperative outcomes, morbidity, functional results and quality of life (Qol).
PATIENTS AND METHODS: From February 2010 to February 2017, a French multicentric, prospective study on patients who had a RC and ONB reconstruction for bladder cancer was performed. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and the bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients also completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Patients were divided in two groups: ORC and RARC.
RESULTS: We included 72 patients: 55 in the ORC group (76,4%) and 17 (33,6%) in the RARC group. Operative time was longer in RARC group (median 360 vs 300min; P<0.001) but length of stay was 5 days shorter (median 12 vs 17 days; P<0,05). Patients in RARC group had less blood transfusion (0 vs 23.6%; P<0.05), but a higher rate of uretero-ileal anastomosis stenosis and eventration at long term (respectively 25.5 vs 3.6% et 23 vs 2%; P<0.05). No statistical differences were found concerning quality of life items and functional results between the groups.
CONCLUSION: RARC with totally IC ONB reconstruction lead to less perioperative morbidity with a reduced rate of blood transfusion and a reduced hospital length of stay. At long term, RARC could provide higher rates of uretero-ileal stenosis and eventration. RARC and ORC do not have any differences in terms of functional outcomes and Qol at long term after ONB reconstruction.
LEVEL OF EVIDENCE: 3.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie - 29(2019), 8-9 vom: 28. Juli, Seite 440-448 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
Morbidité, résultat fonctionnel, et qualité de vie des néovessies après cystectomie pour cancer : comparaison de la voie ouverte vs robotique |
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| Beteiligte Personen: |
Tostivint, V [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 16.01.2020 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.purol.2019.05.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM298531836 |
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| 245 | 1 | 0 | |a Orthotopic neobladder reconstruction for bladder cancer |b robotic-assisted versus open-radical cystectomy for perioperative outcomes, functional results and quality of life |
| 246 | 3 | 3 | |a Morbidité, résultat fonctionnel, et qualité de vie des néovessies après cystectomie pour cancer : comparaison de la voie ouverte vs robotique |
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| 500 | |a Date Completed 16.01.2020 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a INTRODUCTION: Open radical cystectomy (ORC) is the gold standard technique for carcinologic cystectomies. Robotic-assisted radical cystectomy (RARC) was introduced in 2003 and its development is booming | ||
| 520 | |a OBJECTIVE: To compare ORC and RARC with totally intracorporal (IC) orthotopic neobladder (ONB) reconstruction, in terms of perioperative outcomes, morbidity, functional results and quality of life (Qol) | ||
| 520 | |a PATIENTS AND METHODS: From February 2010 to February 2017, a French multicentric, prospective study on patients who had a RC and ONB reconstruction for bladder cancer was performed. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and the bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients also completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Patients were divided in two groups: ORC and RARC | ||
| 520 | |a RESULTS: We included 72 patients: 55 in the ORC group (76,4%) and 17 (33,6%) in the RARC group. Operative time was longer in RARC group (median 360 vs 300min; P<0.001) but length of stay was 5 days shorter (median 12 vs 17 days; P<0,05). Patients in RARC group had less blood transfusion (0 vs 23.6%; P<0.05), but a higher rate of uretero-ileal anastomosis stenosis and eventration at long term (respectively 25.5 vs 3.6% et 23 vs 2%; P<0.05). No statistical differences were found concerning quality of life items and functional results between the groups | ||
| 520 | |a CONCLUSION: RARC with totally IC ONB reconstruction lead to less perioperative morbidity with a reduced rate of blood transfusion and a reduced hospital length of stay. At long term, RARC could provide higher rates of uretero-ileal stenosis and eventration. RARC and ORC do not have any differences in terms of functional outcomes and Qol at long term after ONB reconstruction | ||
| 520 | |a LEVEL OF EVIDENCE: 3 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Bladder cancer | |
| 650 | 4 | |a Cancer de la vessie | |
| 650 | 4 | |a Cystectomie | |
| 650 | 4 | |a Cystectomy | |
| 650 | 4 | |a Laparoscopie | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Laparotomie | |
| 650 | 4 | |a Néovessie orthotopique | |
| 650 | 4 | |a Open | |
| 650 | 4 | |a Orthotopic neobladder | |
| 650 | 4 | |a Quality of life | |
| 650 | 4 | |a Qualité de vie | |
| 650 | 4 | |a Robot assistance | |
| 650 | 4 | |a Robotic | |
| 700 | 1 | |a Roumiguié, M |e verfasserin |4 aut | |
| 700 | 1 | |a Cabarrou, B |e verfasserin |4 aut | |
| 700 | 1 | |a Verhoest, G |e verfasserin |4 aut | |
| 700 | 1 | |a Gas, J |e verfasserin |4 aut | |
| 700 | 1 | |a Coloby, P |e verfasserin |4 aut | |
| 700 | 1 | |a Soulié, M |e verfasserin |4 aut | |
| 700 | 1 | |a Thoulouzan, M |e verfasserin |4 aut | |
| 700 | 1 | |a Beauval, J-B |e verfasserin |4 aut | |
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