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Complications of Robot-Assisted Radical Cystectomy

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Robotic Urologic Surgery

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Abstract

The reduction of surgical morbidity is the keystone of minimally invasive robot-assisted surgery. As techniques have advanced, the focus on perioperative outcomes has magnified. The shift from open to robot-assisted radical cystectomy (RARC) has resulted in the reduction of risks but has stoked debates about optimal technique—especially with respect to urinary diversion. In this chapter, we discuss the current evidence-based knowledge of perioperative outcomes and complications after RARC.

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References

  1. Zhang JH, Ericson KJ, Thomas LJ, Knorr J, Khanna A, Crane A, et al. Large single institution comparison of perioperative outcomes and complications of open radical cystectomy, intracorporeal robot-assisted radical cystectomy and robotic extracorporeal approach. J Urol. 2020;203(3):512–21. https://doi.org/10.1097/JU.0000000000000570.

    Article  PubMed  Google Scholar 

  2. Novara G, Catto JW, Wilson T, Annerstedt M, Chan K, Murphy DG, et al. Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy. Eur Urol. 2015;67(3):376–401. https://doi.org/10.1016/j.eururo.2014.12.007.

    Article  PubMed  Google Scholar 

  3. Hussein AA, Elsayed AS, Aldhaam NA, Jing Z, Peabody JO, Wijburg CJ, et al. A comparative propensity score-matched analysis of perioperative outcomes of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. BJU Int. 2020;126(2):265–72. https://doi.org/10.1111/bju.15083.

    Article  PubMed  Google Scholar 

  4. Johar RS, Hayn MH, Stegemann AP, Ahmed K, Agarwal P, Balbay MD, et al. Complications after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. Eur Urol. 2013;64(1):52–7. https://doi.org/10.1016/j.eururo.2013.01.010.

    Article  PubMed  Google Scholar 

  5. Kauffman EC, Ng CK, Lee MM, Otto BJ, Portnoff A, Wang GJ, et al. Critical analysis of complications after robotic-assisted radical cystectomy with identification of preoperative and operative risk factors. BJU Int. 2010;105(4):520–7. https://doi.org/10.1111/j.1464-410X.2009.08843.x.

    Article  PubMed  Google Scholar 

  6. Parekh DJ, Reis IM, Castle EP, Gonzalgo ML, Woods ME, Svatek RS, et al. Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial. Lancet. 2018;391(10139):2525–36. https://doi.org/10.1016/S0140-6736(18)30996-6.

    Article  PubMed  Google Scholar 

  7. Mazzone E, D'Hondt F, Beato S, Andras I, Lambert E, Vollemaere J, et al. Robot-assisted radical cystectomy with intracorporeal urinary diversion decreases postoperative complications only in highly comorbid patients: findings that rely on a standardized methodology recommended by the European Association of Urology Guidelines. World J Urol. 2021;39(3):803–12. https://doi.org/10.1007/s00345-020-03237-5.

    Article  PubMed  Google Scholar 

  8. Smith AB, Raynor M, Amling CL, Busby JE, Castle E, Davis R, et al. Multi-institutional analysis of robotic radical cystectomy for bladder cancer: perioperative outcomes and complications in 227 patients. J Laparoendosc Adv Surg Tech A. 2012;22(1):17–21. https://doi.org/10.1089/lap.2011.0326.

    Article  PubMed  Google Scholar 

  9. Ahmed K, Khan SA, Hayn MH, Agarwal PK, Badani KK, Balbay MD, et al. Analysis of intracorporeal compared with extracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. Eur Urol. 2014;65(2):340–7. https://doi.org/10.1016/j.eururo.2013.09.042.

    Article  PubMed  Google Scholar 

  10. Mitropoulos D, Artibani W, Graefen M, Remzi M, Rouprêt M, Truss M, et al. Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol. 2012;61(2):341–9. https://doi.org/10.1016/j.eururo.2011.10.033.

    Article  PubMed  Google Scholar 

  11. Dell'Oglio P, Andras I, Ortega D, Galfano A, Artibani W, Autorino R, et al. Impact of the implementation of the EAU guidelines recommendation on reporting and grading of complications in patients undergoing robot-assisted radical cystectomy: a systematic review. Eur Urol. 2021; https://doi.org/10.1016/j.eururo.2021.04.030.

  12. Bochner BH, Dalbagni G, Sjoberg DD, Silberstein J, Keren Paz GE, Donat SM, et al. Comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: a randomized clinical trial. Eur Urol. 2015;67(6):1042–50. https://doi.org/10.1016/j.eururo.2014.11.043.

    Article  PubMed  Google Scholar 

  13. Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol. 2010;57(2):196–201. https://doi.org/10.1016/j.eururo.2009.10.024.

    Article  PubMed  Google Scholar 

  14. Khan MS, Gan C, Ahmed K, Ismail AF, Watkins J, Summers JA, et al. A single-centre early phase randomised controlled three-arm trial of open, robotic, and laparoscopic radical cystectomy (CORAL). Eur Urol. 2016;69(4):613–21. https://doi.org/10.1016/j.eururo.2015.07.038.

    Article  PubMed  Google Scholar 

  15. Bochner BH, Dalbagni G, Marzouk KH, Sjoberg DD, Lee J, Donat SM, et al. Randomized trial comparing open radical cystectomy and robot-assisted laparoscopic radical cystectomy: oncologic outcomes. Eur Urol. 2018;74(4):465–71. https://doi.org/10.1016/j.eururo.2018.04.030.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol. 2013;189(2):474–9. https://doi.org/10.1016/j.juro.2012.09.077.

    Article  PubMed  Google Scholar 

  17. Shi H, Li J, Li K, Yang X, Zhu Z, Tian D. Minimally invasive versus open radical cystectomy for bladder cancer: a systematic review and meta-analysis. J Int Med Res. 2019;47(10):4604–18. https://doi.org/10.1177/0300060519864806.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Satkunasivam R, Wallis CJ, Nam RK, Desai M, Gill IS. Contemporary evidence for robot-assisted radical cystectomy for treating bladder cancer. Nat Rev Urol. 2016;13(9):533–9. https://doi.org/10.1038/nrurol.2016.139.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bertolo R, Agudelo J, Garisto J, Armanyous S, Fergany A, Kaouk J. Perioperative outcomes and complications after robotic radical cystectomy with intracorporeal or extracorporeal ileal conduit urinary diversion: head-to-head comparison from a single-institutional prospective study. Urology. 2019;129:98–105. https://doi.org/10.1016/j.urology.2018.11.059.

    Article  PubMed  Google Scholar 

  20. Lenfant L, Verhoest G, Campi R, Parra J, Graffeille V, Masson-Lecomte A, et al. Perioperative outcomes and complications of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy for bladder cancer: a real-life, multi-institutional french study. World J Urol. 2018;36(11):1711–8. https://doi.org/10.1007/s00345-018-2313-8.

    Article  PubMed  Google Scholar 

  21. Carrion A, Piñero A, Raventós C, Lozano F, Díaz F, Morote J. Comparison of perioperative outcomes and complications of robot assisted radical cystectomy with extracorporeal vs intracorporeal urinary diversion. Actas Urol Esp (Engl Ed). 2019;43(6):277–83. https://doi.org/10.1016/j.acuro.2019.01.006.

    Article  CAS  PubMed  Google Scholar 

  22. Pyun JH, Kim HK, Cho S, Kang SG, Cheon J, Lee JG, et al. Robot-assisted radical cystectomy with total intracorporeal urinary diversion: comparative analysis with extracorporeal urinary diversion. J Laparoendosc Adv Surg Tech A. 2016;26(5):349–55. https://doi.org/10.1089/lap.2015.0543.

    Article  PubMed  Google Scholar 

  23. Shim JS, Kwon TG, Rha KH, Lee YG, Lee JY, Jeong BC, et al. Do patients benefit from total intracorporeal robotic radical cystectomy?: a comparative analysis with extracorporeal robotic radical cystectomy from a Korean multicenter study. Investig Clin Urol. 2020;61(1):11–8. https://doi.org/10.4111/icu.2020.61.1.11.

    Article  PubMed  Google Scholar 

  24. Tan TW, Nair R, Saad S, Thurairaja R, Khan MS. Safe transition from extracorporeal to intracorporeal urinary diversion following robot-assisted cystectomy: a recipe for reducing operative time, blood loss and complication rates. World J Urol. 2019;37(2):367–72. https://doi.org/10.1007/s00345-018-2386-4.

    Article  PubMed  Google Scholar 

  25. Hussein AA, May PR, Jing Z, Ahmed YE, Wijburg CJ, Canda AE, et al. Outcomes of intracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium. J Urol. 2018;199(5):1302–11. https://doi.org/10.1016/j.juro.2017.12.045.

    Article  PubMed  Google Scholar 

  26. Mistretta FA, Musi G, Collà Ruvolo C, Conti A, Luzzago S, Catellani M, et al. Robot-assisted radical cystectomy for nonmetastatic urothelial carcinoma of urinary bladder: a comparison between intracorporeal versus extracorporeal orthotopic ileal neobladder. J Endourol. 2021;35(2):151–8. https://doi.org/10.1089/end.2020.0622.

    Article  PubMed  Google Scholar 

  27. Katayama S, Mori K, Pradere B, Mostafaei H, Schuettfort VM, Quhal F, et al. Intracorporeal versus extracorporeal urinary diversion in robot-assisted radical cystectomy: a systematic review and meta-analysis. Int J Clin Oncol. 2021;26(9):1587–99. https://doi.org/10.1007/s10147-021-01972-2.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tanneru K, Jazayeri SB, Kumar J, Alam MU, Norez D, Nguyen S, et al. Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review. J Robot Surg. 2021;15(3):321–33. https://doi.org/10.1007/s11701-020-01174-4.

    Article  PubMed  Google Scholar 

  29. Bruins HM, Veskimäe E, Hernández V, Neuzillet Y, Cathomas R, Compérat EM, et al. The importance of hospital and surgeon volume as major determinants of morbidity and mortality after radical cystectomy for bladder cancer: a systematic review and recommendations by the European Association of Urology Muscle-invasive and Metastatic Bladder Cancer Guideline Panel. Eur Urol Oncol. 2020;3(2):131–44. https://doi.org/10.1016/j.euo.2019.11.005.

    Article  PubMed  Google Scholar 

  30. Soria F, Moschini M, D'andrea D, Abufaraj M, Foerster B, Mathiéu R, et al. Comparative effectiveness in perioperative outcomes of robotic versus open radical cystectomy: results from a multicenter contemporary retrospective cohort study. Eur Urol Focus. 2020;6(6):1233–9. https://doi.org/10.1016/j.euf.2018.11.002.

    Article  PubMed  Google Scholar 

  31. Guru KA, Wilding GE, Piacente P, Thompson J, Deng W, Kim HL, et al. Robot-assisted radical cystectomy versus open radical cystectomy: assessment of postoperative pain. Can J Urol. 2007;14(6):3753–6.

    PubMed  Google Scholar 

  32. Salimath J, Jones MW, Hunt DL, Lane MK. Comparison of return of bowel function and length of stay in patients undergoing laparoscopic versus open colectomy. JSLS. 2007;11(1):72–5.

    PubMed  PubMed Central  Google Scholar 

  33. Messer JC, Punnen S, Fitzgerald J, Svatek R, Parekh DJ. Health-related quality of life from a prospective randomised clinical trial of robot-assisted laparoscopic vs open radical cystectomy. BJU Int. 2014;114(6):896–902. https://doi.org/10.1111/bju.12818.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Ralph Grauer, John P. Sfakianos, Reza Mehrazin & Peter Wiklund

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  1. Ralph Grauer
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  2. John P. Sfakianos
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  3. Reza Mehrazin
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  4. Peter Wiklund
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Editor information

Editors and Affiliations

  1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA

    Peter Wiklund

  2. Department of Urology, ORSI Academy, Aalst, Belgium

    Alexandre Mottrie

  3. Pediatric Urology, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA

    Mohan S Gundeti

  4. Urology, Global Robotics Institute, Celebration, FL, USA

    Vipul Patel

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Grauer, R., Sfakianos, J.P., Mehrazin, R., Wiklund, P. (2022). Complications of Robot-Assisted Radical Cystectomy. In: Wiklund, P., Mottrie, A., Gundeti, M.S., Patel, V. (eds) Robotic Urologic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-00363-9_64

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  • DOI: https://doi.org/10.1007/978-3-031-00363-9_64

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-00362-2

  • Online ISBN: 978-3-031-00363-9

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