title: Peri- and postoperative outcomes of robot-assisted radical cystectomy (RARC).
abstract: 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.
  
  
  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.
authors.affiliation: Division of Urologic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7235, USA.
authors.forename: Angela B
authors.initials: AB
authors.lastname: Smith
authors.forename: Mathew C
authors.initials: MC
authors.lastname: Raynor
authors.forename: Raj S
authors.initials: RS
authors.lastname: Pruthi
mesh_terms: D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010388:Pelvis; D011184:Postoperative Period; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*