Abstract
Purpose
To evaluate urinary outcomes of pelvic construction and lateral capsule sparing techniques in robot-assisted radical cystectomy with orthotopic ileal neobladder (RARC-OIN).
Methods
A total of 107 male patients who underwent RARC-OIN during January 2017 and February 2021 in Sun Yat-sen Memorial Hospital were analyzed retrospectively. Standard RARC-OIN with or without nerve sparing technique was performed in 44 patients (standard group), lateral prostate capsule sparing technique was performed in 20 patients (LCS group), combined pelvic reconstruction (CPR) technique including anterior suspension and posterior reconstruction were performed in 43 patients (CPR group). The urinary function was assessed by the use of pads and the Bladder Cancer Index (BCI). Continence was defined as the use of 0–1 pad during daytime or night-time.
Results
There was no statistical difference between the three groups regarding demographic, perioperative, and pathological data. Continence rates were 6.8, 50.0 and 34.9% for daytime, 4.6, 40.0 and 32.6% for night-time in the standard group, LCS group and CPR group at 1 month post-operation, respectively. Continence rates were 34.1, 80.0 and 69.8% for daytime, 27.3, 75.0 and 65.1% for night-time in the standard group, LCS group and CPR group at 3 month post-operation, respectively. No statistically significant difference was observed in the daytime and night-time continence rates at 12 months.
Conclusions
Lateral capsule-sparing and combined pelvic reconstruction techniques are feasible to improve early daytime and night-time continence rates in RARC with orthotopic neobladder.
Clinical trial registration
The trial registration number: ChiCTR2100047606.
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Funding
This study was funded by the National Key Research and Development Program of China (Grant No. 2018YFA0902803, 2017YFC1308600); the National Natural Science Foundation of China (Grant No. 81825016, 81802530, 81830082, 81672395, 81871945, 81772719, 81772728, 2072639, 91740119, 81472381, 81972385, 82173266, 81802552); the Key Areas Research and Development Program of Guangdong (Grant No. 2020A1515010815, 2018B010109006, 2017A020215072); the Science and Technology Planning Project of Guangdong Province (Grant No. 202002030388, 201803010049, 2017B020227007, 201704020097); Guangdong Clinical Research Center for Urological Diseases(Grant No. 2020B1111170006); Yixian Youth project of Sun Yat-sen Memorial Hospital (Grant No. YXQH201812); Young Teacher Training Funding of Sun Yat-sen University (Grant No. 19ykzd21, 19ykpy121); Science and Technology Program of Guangzhou, China (Grant No.201904010004); Natural Science Foundation of Guangdong Province, China (Grant No.2018A030313545).
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All authors contributed to the study’s conception and design. W He: Conception of research, Manuscript writing. JT Yang: Data collection, Manuscript writing. MC Gao: Data collection, Statistical analysis. H Liu: Review of the draft. JB Li: Quality control. JT Hu: Statistical analysis. YS Zhang: Statistical analysis. GZ Zhong: Statistical analysis. KW Li: Data collection. WD: Data collection. H Huang: Manuscript preparation. TL: Conception of research, Quality control. J Huang: Conception of research, Quality control. All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the Journal of Endourology.
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The authors have no relevant financial or non-financial interests to disclose.
Research involving human participants
The study was an observational retrospective study and approved by the ethics committee of Sun Yat-sen Memorial Hospital (Approval No. SYSEC-KY-KS-2021–136). All procedures performed in studies involving human participants were under the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. We have received broad consent from the ethics committee of Sun Yat-sen Memorial Hospital.
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11255_2022_3214_MOESM1_ESM.eps
Figure S1 Subgroup analysis: Kaplan-Meier curves showing the probability of postoperative daytime (a) and nighttime (b) continence in NVB sparing, NVB combined with CPR and LCS patients. (EPS 13 KB)
11255_2022_3214_MOESM2_ESM.eps
Figure S2 Kaplan-Meier curves showing the probability of postoperative daytime and nighttime continence after RARC in the standard group (a, b) and CPR group (c, d) according to nerve sparing procedure. (EPS 20 KB)
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He, W., Yang, J., Gao, M. et al. Pelvic reconstruction and lateral prostate capsule sparing techniques improve early continence of robot-assisted radical cystectomy with orthotopic ileal neobladder. Int Urol Nephrol 54, 1537–1543 (2022). https://doi.org/10.1007/s11255-022-03214-4
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DOI: https://doi.org/10.1007/s11255-022-03214-4