title: [Radical cystectomy with orthotopic neobladder replacement: Comparison of robotic assisted and open surgical route].
abstract: BACKGROUND
  Radical cystectomy remains the referent treatment of non-metastatic muscle-invasive bladder cancer (MIBC). The fast development of robotic surgery has led some teams to use it for the surgical treatment of the MIBC, in the hope of reducing postoperative morbidity. Urinary diversion by bladder substitution is a bypass option. The aim of our study was to compare the robot-assisted cystectomy with open cystectomy, with urinary diversion by bladder substitution.
  
  
  METHODS
  Over a two-year period, all the patients who underwent a robot-assisted laparoscopic or open cystectomy with urinary diversion by bladder substitution have been included. The urinary diversion performed was extra-corporeal.
  
  
  RESULTS
  The study concerned were 26 men, 15 of them underwent robot-assisted cystectomy, and 11 open cystectomy. There was no significant difference in the median operating time or duration of stay (300 vs 314min and 14 vs 18 days). However, there were less blood loss and more lymph nodes collected in the cystectomies robot-assisted group (median: 400 vs 800mL, P=0.016; 15 vs 10, P=0.01). Three grade III complications of the Clavien-Dindo classification have been described in the robot-assisted group, and none in the open group. No robot-assisted procedure required a conversion to laparotomy. Within 90 postoperative days, complications are basically low grades and results are consistent with the literature.
  
  
  CONCLUSIONS
  In our series, robot-assisted cystectomies with extracorporeal bladder substitution is technically feasible, with best results on blood loss and the number of lymph nodes removed, without impact on the length of stay.
  
  
  METHODS
  4.
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France. Electronic address: raphaelginot@hotmail.fr.
authors.forename: R
authors.initials: R
authors.lastname: Ginot
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Rouget
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France; Observatoire national de la démographie et des données en urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Bensadoun
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: G
authors.initials: G
authors.lastname: Pasticier
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Bernhard
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: G
authors.initials: G
authors.lastname: Capon
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Ferrière
authors.affiliation: Service d'urologie et de transplantation rénale, CHU de Bordeaux, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: G
authors.initials: G
authors.lastname: Robert
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent
keywords: Bladder cancer; Cystectomie robot-assistée; Cystectomy; Orthotopic neobladder; Outcomes; Remplacement vésical orthotopique; Robotic; Résultats; Tumeur de vessie