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Robot-Assisted Laparoscopic Cystoprostatectomy with Extended Pelvic Lymphadenectomy, Extracorporeal Enterocystoplasty, and Intracorporeal Enterourethral Anastomosis: Initial Montsouris Experience

2010; Mary Ann Liebert, Inc.; Volume: 24; Issue: 3 Linguagem: Inglês

10.1089/end.2009.0209

1557-900X

Ali Kasraeian, Éric Barret, Xavier Cathelineau, François Rozet, Marc Galiano, Rafael Sánchez-Salas, Guy Vallancien,

Ureteral procedures and complications

Radical cystectomy is the gold standard for management of invasive and recurrent high-grade superficial bladder cancer. We present our initial experience with robot-assisted laparoscopic cystoprostatectomy (RALCP) with extended pelvic lymphadenectomy (epLAD) and intracorporeal enterourethral anastomosis (IEUA). A video demonstrating our technique is available online at www.liebertonline.com/end.Between April 2008 and March 2009, nine patients underwent RALCP with epLAD and IEUA at our institution. Operative technique, as described in detail (with video), was assessed for feasibility. A video demonstrating this technique is available online at www.liebertonline.com/end. Preoperative patient characteristics, operative data, as well as perioperative and pathologic outcomes were analyzed. All data were collected prospectively.Median total operative time was 270 minutes (range 210-330): 60 minutes, bilateral epLAD; 90 minutes, RALCP; 60 minutes, open enterocystoplasty; 60 minutes (range 45-90), IEUA. Median blood loss was 400 mL (range 200-900 mL). All surgical margins were negative. Median number of lymph nodes removed was 11 (range 4-21). Postoperative complications were noted in three patients and included urinoma (n = 1), pyelonephritis (n = 1), and hematoma (n = 1).RALCP is feasible and can be performed safely and effectively with acceptable operative, pathologic, and short-term clinical outcomes. More experience with longer follow-up is necessary to further assess clinical and oncologic outcomes of robotic assisted laparoscopic cystectomy for treatment of bladder cancer.