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01-12-2024 | Ureterocutaneostomy | Original Article

Robotic-assisted radical cystectomy with cutaneous ureterostomies: a contemporary multicenter analysis

Authors: Reuben Ben-David, Francesco Pellegrino, Parissa Alerasool, Neeraja Tillu, Etienne Lavallee, Kyrollis Attalla, Nikhil Waingankar, Sfakianos P. John, Reza Mehrazin, Marco Moschini, Alberto Martini, Sebastian Edeling, Alberto Briganti, Francesco Montorsi, Peter Wiklund

Published in: World Journal of Urology | Issue 1/2024

Abstract

Background

Robotic-assisted radical cystectomy (RARC) offers decreased blood loss during surgery, shorter hospital length of stay, and lower risk for thromboembolic events without hindering oncological outcomes. Cutaneous ureterostomies (UCS) are a seldom utilized diversion that can be a suitable alternative for a selected group of patients with competing co-morbidities and limited life expectancy.

Objective

To describe operative and perioperative characteristics as well as oncological outcomes for patients that underwent RARC + UCS.

Methods

Patients that underwent RARC + UCS during 2013–2023 in 3 centers (EU = 2, US = 1) were identified in a prospectively maintained database. Baseline characteristics, pathological, and oncological outcomes were analyzed. Descriptive statistics and survival analysis were performed using R language version 4.3.1.

Results

Sixty-nine patients were included. The median age was 77 years (IQR 70–80) and the median follow-up time was 11 months (IQR 4–20). Ten patients were ASA 4 (14.5%). Nine patients underwent palliative cystectomy (13%). The median operation time was 241 min (IQR 202–290), and the median hospital stay was 8 days (IQR 6–11). The 30-day complication rate was 55.1% (grade ≥ 3a was 14.4%), and the 30-day readmission rate was 17.4%. Eleven patients developed metastatic recurrence (15.9%), and 14 patients (20.2%) died during the follow-up period. Overall survival at 6, 12, and 24 months was 84%, 81%, and 73%, respectively.

Conclusions

RARC + UCS may offer lower complication and readmission rates without the need to perform enteric anastomosis, it can be considered in a selected group of patients with competing co-morbidities, or limited life expectancy. Larger prospective studies are necessary to validate these results.

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Title: Robotic-assisted radical cystectomy with cutaneous ureterostomies: a contemporary multicenter analysis
Authors: Reuben Ben-David
Francesco Pellegrino
Parissa Alerasool
Neeraja Tillu
Etienne Lavallee
Kyrollis Attalla
Nikhil Waingankar
Sfakianos P. John
Reza Mehrazin
Marco Moschini
Alberto Martini
Sebastian Edeling
Alberto Briganti
Francesco Montorsi
Peter Wiklund
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Ureterocutaneostomy
Cystectomy
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04942-1

2024 ASCO Annual Meeting

Springer Medicine

Robotic-assisted radical cystectomy with cutaneous ureterostomies: a contemporary multicenter analysis

Abstract

Background

Objective

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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