title: Robot-assisted radical cystoprostatectomy: Analysis of the complications and oncological and functional aspects.
abstract: OBJECTIVE
  To review our experience in robot-assisted radical cystectomy, assessing the complications and oncological and functional results.
  
  
  METHODS
  From 2007 to 2014, we performed 67 robot-assisted radical cystectomies combined with lymphadenectomy in 61 cases. The operations were performed on 37 patients due to muscle-invasive tumours and on 30 due to high-risk nonmuscle-invasive tumours. Urinary diversion was conducted extracorporeally, using a Studer neobladder in 47 cases.
  
  
  RESULTS
  The mean blood loss was 300mL. No case required conversion to open surgery. The median number of lymph nodes extracted was 16 (range 3-33). Pathology revealed 16 pT0, 15 pTis,-pT1-pTa and 44 muscle-invasive tumours, 8 pN+ and 1 with positive margins. The mean hospital stay was 9 days. With a median follow-up of 16 months, 9 (13%) patients were readmitted after the discharge, most for infections associated with the vesical catheter and other catheters. Forty patients (59.7%) presented complications (most were Clavien grade 1-2). There was recurrence during the follow-up in 4 cases (6%), and 4 (5.9%) patients died from cancer. Nineteen (28.3%) patients had complications after 30 days, most of which were urinary tract infections. Of the 47 patients with a neobladder, 45 (96%) had proper daytime continence and 42 (89%) had proper nighttime continence. Ninety percent and 64% of the patients with previously normal sexual function and reduced sexual function, respectively, were able to preserve sexual function with or without drug treatment.
  
  
  CONCLUSIONS
  Robot-assisted radical cystectomy plus lymphadenectomy, with extracorporeal reconstruction of the urinary diversion, offers good oncological and functional results without increasing the number of complications.
authors: Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, España.
authors: A
authors: A
authors: Kanashiro
authors: Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, España.
authors: J M
authors: JM
authors: Gaya
authors: Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: jpalou@fundacio-puigvert.es.
authors: J
authors: J
authors: Palou
authors: Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, España.
authors: L
authors: L
authors: Gausa
authors: Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, España.
authors: H
authors: H
authors: Villavicencio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: Bladder cancer; Cistectomía radical; Cáncer de vejiga; Derivación urinaria; Neobladder; Neovejiga; Radical cystectomy; Robot; Urinary diversion