title: [Oncologic and perioperative outcomes of robot-assisted radical cystectomy: A single-center prospective series].
abstract: BACKGROUND
  The aim of this study was to report perioperative and oncological outcomes of robot-assisted radical cystectomy (RARC) in a single-center series and to evaluate the impact of the experience on perioperative outcomes.
  
  
  METHODS
  Between March 2012 and January 2016, 41 patients underwent RARC associated with extended pelvic lymphadenectomy for muscle-invasive bladder cancer. All RARC included were performed by a single-surgeon in one center. Perioperative and oncological datas were collected prospectively. Recurrence-free (RFS), overall (OS) and cancer-specific survivals (CSS) were estimated using the Kaplan-Meier Method. The impact of the experience on perioperative data was estimated using Spearman's correlation test.
  
  
  RESULTS
  Mean age was 67,7years (±10.6). Most patients underwent neoadjuvant chemotherapy (73.2%). Mean operative time and mean estimated blood loss were respectively 319.5minutes (±85.3) and 662.5mL (±360.9). Eight patients needed perioperative blood transfusion (19.5%). Conversion to open surgery was necessary in 3 cases (7.3%). Ileal neobladder was performed in 26.8% of the cases (54.5% being performed intracorporeal), and non-continent urinary diversion in 73.2%. Mean nodal yield was 17.7 (±9.3). Positive surgical margins were observed in 1 patient (2.3%). Mean length of stay was 13.2 days (±9.8). Postoperative complication rate was 46,3%. After a median follow-up of 16months, estimated 2 year-OS and CSS were respectively 62 and 76.1%. Estimated 2-year RFS was 67.6%. Perioperative outcomes improved with experience with a significant decrease in operative time (P=0.04) and a significant increase of nodal yield (P=0.05).
  
  
  CONCLUSIONS
  In this single-center prospective study, satisfactory perioperative and oncological outcomes after RARC were observed despite the learning curve. Perioperative outcomes improved with surgeon's experience. Further studies are needed to confirm these findings.
  
  
  METHODS
  4.
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France. Electronic address: quentin.alimi@gmail.com.
authors: Q
authors: Q
authors: Alimi
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: B
authors: B
authors: Peyronnet
authors: Department of pathology, CHU de Rennes, 35000 Rennes, France.
authors: S-F
authors: SF
authors: Kammerer-Jacquet
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: M
authors: M
authors: Lefevre
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: B
authors: B
authors: Gires
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: R
authors: R
authors: Mathieu
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: L
authors: L
authors: Tondut
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: S
authors: S
authors: Vincendeau
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: A
authors: A
authors: Manunta
authors: Department of pathology, CHU de Rennes, 35000 Rennes, France.
authors: N
authors: N
authors: Rioux-Leclercq
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: F
authors: F
authors: Guille
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: K
authors: K
authors: Bensalah
authors: Department of urology, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors: G
authors: G
authors: Verhoest
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D065287:Robotic Surgical Procedures; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000601:surgery*
keywords: Bladder cancer; Cancer de vessie; Cystectomie; Cystectomy; Ileal neobladder; Néovessie de remplacement; Robot