Impact of outcomes and costs for implementation of robotic radical cystectomy with full intracorporeal urinary diversion.

Introduction: Radical cystectomy (RC) remains a surgery with important morbidity despite technical advances. Our aim was to determine the impact on outcomes and costs of robot-assisted radical cystectomy (RARC) with full intracorporeal diversion.

Material And Methods: We retrospectively included 196 consecutive patients undergone RC for bladder cancer between 2017 and 2022.

Not Only Length Matters! Impact of the Ileal Width on the Capacity of the Orthotopic Neobladder: The AADAPT Formula Tested on the Animal Model.

Background: The capacity of a given shape of an orthotopic ileal neobladder (ONB) varies significantly, although the same length of preterminal ileum is utilised.

Objective: To investigate the variability of the human ileal width and to create a mathematical formula that calculates its impact on the neobladder capacity.

Design Setting And Participants: During 50 consecutive cases of robotic pelvic surgery, a segment of preterminal ileum was identified and the width was measured.

A case of large-cell undifferentiated carcinoma of the bladder.

Large-cell undifferentiated carcinoma of the urinary bladder is an extremely rare and aggressive neoplasm. We present a unique case of painless gross hematuria and a past surgical history of cystolithotomy. The patient underwent transurethral resection of the bladder tumor, which revealed high-grade urothelial cell carcinoma with lamina propria involvement.

Ileal conduit to small intestine fistula following extensive abdominopelvic resection and radiation for metastatic colon cancer.

A woman in her mid-60s presented with decreased output from urostomy, which was an opening from the neobladder (ileal conduit). Presentation was preceded by a 6-month history of alternating faecaluria and increased colostomy output. Laboratory studies were notable for normal anion gap metabolic acidosis.

Atlas of Intracorporeal Orthotopic Neobladder Techniques After Robot-assisted Radical Cystectomy and Systematic Review of Clinical Outcomes.

Background: Multiple and heterogeneous techniques have been described for orthotopic neobladder (ONB) reconstruction after robot-assisted radical cystectomy. Nonetheless, a systematic assessment of all the available options is lacking.

Objective: To provide the first comprehensive step-by-step description of all the available techniques for robotic intracorporeal ONB together with individual intraoperative, perioperative and functional outcomes based on a systematic review of the literature.

Quality of life after definitive treatment for bladder cancer: A systematic review and meta-analysis.

Radical cystectomy (RC) is considered the standard treatment for muscle invasive bladder cancer (MIBC). However, RC is often burdened by significant impact on quality of life (QoL); Continence preserving methods (e.g.

Contemporary outcomes of patients undergoing robotic-assisted radical cystectomy: A comparative analysis between intracorporeal ileal conduit and neobladder urinary diversions.

Objective: We aimed to compare perioperative and oncologic outcomes for patients undergoing robotic-assisted radical cystectomy (RARC) with intracorporeal ileal conduit (IC) and neobladder (NB) urinary diversion.

Methods: Patients undergoing RARC with intracorporeal urinary diversion between January 2017 and January 2022 at the Icahn School of Medicine at Mount Sinai, New York, NY, USA were indexed. Baseline demographics, clinical characteristics, perioperative, and oncologic outcomes were analyzed.

Impact of urinary diversion type on urethral recurrence following radical cystectomy for bladder cancer: propensity score matched and weighted analyses of retrospective cohort.

Background: The absence of randomized controlled trials and the presence of inherent selection bias in existing studies have led to ongoing uncertainty regarding the impact of urinary diversion (UD) type (orthotopic UD or nonorthotopic UD) on urethral recurrence (UR) following radical cystectomy (RC) for bladder cancer. This study aimed to assess the impact of the UD types on UR after RC and to identify predictive factors associated with UR.

Materials And Methods: This retrospective analysis encompassed 612 male patients who underwent RC for urothelial carcinoma of the bladder.

Laparoscopic Radical Cystectomy with Ileal Orthotopic Neobladder for Bladder Cancer: Current Indications and Outcomes.

Background: Laparoscopic radical cystectomy (LRC) with ileal orthotopic neobladder (IONB) reconstruction is one of the most promising methods for bladder cancer treatment; its advantages include a small incision size, less blood loss, improved perioperative outcome and tumor prognosis, and a positive self-image postoperatively. The short-term benefits of various IONB reconstruction procedures reported thus far include a simple process, short operative time, less intraoperative bleeding, few postoperative complications, and good postoperative neobladder function; in the long term, these benefits engender good quality of life of the patients. Here, we explored and summarized the more novel and available IONB reconstruction procedures to identify the safest, most efficient, and simplest IONB reconstruction techniques for patients with bladder cancer.

Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country.

Objectives: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran.

Patients And Methods: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD.

[Experience of using Experience of using NefroBest-N for rehabilitation of patients undergoing radical laparoscopic cystectomy].

Aim: To evaluate the efficacy and safety of NefroBest-N in patients undergoing to the radical cystectomy with neobladder formation.

Materials And Methods: A total of 60 patients with invasive bladder cancer aged 56 to 75 years, treated at A.I.

Infections After Adoption of Antibiogram-directed Prophylaxis and Intracorporeal Urinary Diversion for Robot-assisted Radical Cystectomy.

Background: Enhanced recovery after surgery (ERAS) has significantly decreased the morbidity associated with radical cystectomy. However, infectious complications including sepsis, urinary tract (UTIs), wound (WIs), and intra-abdominal (AIs) infections remain common.

Objective: To assess whether intracorporeal urinary diversion (ICUD) and antibiogram-directed antimicrobial prophylaxis would decrease infections after robotic-assisted radical cystectomy (RARC).

Double-Layered Hand-Sewn versus Stapled Intestinal Anastomosis in Patients Who Underwent Ileal Urinary Diversion in Radical Cystectomy: A Comparative and Cost Effective Study.

Introduction: Intestinal anastomosis can be performed by hand suturing (single layer or double layer) or by a mechanical suturing machine. The aim of the study was to compare complications, operative time, and costs of the intestinal anastomosis techniques.

Methods: A retrospective comparative study was conducted including patients who underwent radical cystectomy and uretero-ileo-cutaneostomy or vescica ileale Padovana orthotopic neobladder.

Microbial Trends in Infection-related Readmissions Following Radical Cystectomy for Bladder Cancer.

Objective: To report microbial pathogens detected at infection-related readmissions, including their susceptibility to antimicrobials.

Materials And Methods: A retrospective review of 785 patients who underwent radical cystectomy for bladder cancer at a tertiary center in Denmark between 2009 and 2019. All patients received prophylactic cefuroxime preoperatively and pivmecillinam at stent- or catheter removal.

Secondary tumours in orthotopic neobladder using isolated gut segment post radical cystectomy for urothelial carcinoma: a systematic review.

Background: Urothelial carcinoma recurrence of an orthotopic neobladder created from bowel segment is a rare occurrence. The usage of bowel segments to create neobladder following cystectomy for urinary diversion is growing yet there still remains a large gap in the literature about recurrence in neobladder. We carry out the first systematic review to outline current details of urothelial cancer recurrences in a neobladder, diagnostic approach, management and long term prognosis.

Prospective evaluation of return to work, health-related quality of life and psychosocial distress after radical cystectomy: 1-year follow-up in 230 employed German bladder cancer patients.

Purpose: To evaluate return to work (RTW), health-related quality of life (HRQoL) and psychosocial distress (PD) after radical cystectomy (RC) and creation of an ileal conduit (IC) or an orthotopic ileal neobladder (NB) for bladder cancer.

Methods: The study relied on prospectively collected data for 842 patients, who underwent 3 weeks of inpatient rehabilitation (IR) after surgery between April 2018 and December 2019. HRQoL (EORTC QLQ-C30) and PD (Questionnaire on Stress in Cancer Patients [QSC-R10]) were evaluated at the beginning (T1) and end (T2) of IR as well as both 6 (T3) and 12 months after surgery (T4).

Outcome of small versus big capacity Hautmann neobladder reconstruction: A prospective randomized study - a 5-year follow up.

Background: Orthotopic urinary diversion is the preferred diversion after cystectomy. Neobladder reconstruction with a longer ileum segment (60 cm) is advantageous for obtaining a large capacity and continence at the beginning; however, the long-term risk of residual urine, chronic infection, and the need for intermittent catheterization is more pronounced with the neobladder constructed with a longer ileal segment compared to the neobladder tailored from the shorter ileal segment.

Objective: To establish the differences in the functional outcome of a shorter (< 45 cm) and longer (⩾ 45 cm) ileal segment usage in the reconstruction of the Hautmann ileal neobladder following the radical cystectomy.

Application of The Paris System in neobladder washing cytology: Comparison between the original diagnosis and correlation with histopathology.

Background: In urinary diversion after radical cystectomy, the incidence of recurrent urothelial carcinoma (UC) in upper urinary tract or urethra are reported in 2%-17% of the patients. Urine cytology plays a pivotal role in detecting the recurrence of UC. However, cytologic diagnosis in urinary diversion including neobladder is often challenging due to significant degenerative changes and necro-inflammatory background.