Comparison of Single-docking Robotic-assisted and Traditional Laparoscopy for Retroperitoneal Lymph Node Dissection During Nephroureterectomy With Bladder Cuff Excision for Upper-tract Urothelial Carcinoma.
OBJECTIVE
To compare the results of traditional laparoscopy and a simple, single-docking robotic approach for retroperitoneal lymph node dissection (RPLND), nephroureterectomy, and bladder cuff excision.


METHODS
We evaluated 63 and 37 consecutive patients who underwent laparoscopic and robotic nephrouretectomy with RPLND, respectively, for upper-tract urothelial carcinoma (UTUC).


RESULTS
Our robotic approach was associated with improved lymph node procurement (21.0 nodes [interquartile range 16.0-30.0]) when compared with laparoscopy (11.0 nodes [interquartile range 5.5-21.0]) (P < .0001). Major blood loss as defined by requiring a blood transfusion was less for the robotic group than for the laparoscopic cohort (8% vs 30%) (P = .012). In contrast, the robotic group had longer operative times (5.1 vs 3.9 hours) (P = .0001) and longer hospital stays (5.0 vs 4.0 days) (P = .0002).


CONCLUSIONS
Our single-docking robotic technique for concomitant RPLND during nephrouretectomy is associated with improved lymph node yield.
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
Jonathan J
JJ
Melquist
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
Grant
G
Redrow
Department of Urology, Louisiana State University, New Orleans, LA.
Scott
S
Delacroix
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
Andrew
A
Park
Department of Urology, Barretos Cancer Hospital, Barretos, Brazil.
Eliney E
EE
Faria
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
Jose A
JA
Karam
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: surmatin@mdanderson.org.
Surena F
SF
Matin
D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*