Complications from robot-assisted radical cystectomy: Where do we stand?
BACKGROUND
Radical cystectomy with extended lymphadenectomy is the surgical treatment of choice for muscle-invasive bladder cancer. The technical and technological improvements and the positive results from robot-assisted kidney and prostate surgery have led to the progressive development of robot-assisted radical cystectomy (RARC). We provide a global structured overview and an update on the complications of RARC, recorded according to the Clavien-Dindo classification system.


METHODS
We conducted a search on PubMed of all publications on RARC to date (2014). Of the 259 publications found, we excluded review articles and cost analyses, publications with less than 30 cases, updates of previous studies and those whose main objective was the study of other issues related to RARC other than complications, leaving a total of 38 articles for the final analysis.
The most common complications associated with RARC are gastrointestinal, infectious and genitourinary system, mainly Clavien 1-2, followed by Clavien 3-4. RARC had lower overall complication rates than open radical cystectomy and laparoscopic radical cystectomy and had a lower incidence of severe complications, less intraoperative bleeding and better postoperative recovery.


CONCLUSIONS
Although further scientific evidence is needed, RARC is an increasingly widespread technique that appears to reduce complications as well as the need for transfusion, and it improves recovery times.
Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, España.
I
I
Guiote
Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, España.
J M
JM
Gaya
Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, España.
L
L
Gausa
Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, España.
O
O
Rodríguez
Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: jpalou@fundacio-puigvert.es.
J
J
Palou
D015653:Cystectomy / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*
Cistectomía radical; Clavien; Complicaciones; Complications; Morbidity; Morbilidad; Radical cystectomy; Robot-assisted; Robótica