FTP3.4 Robotic bladder-sparing exenterations for advanced rectal cancers - Short term outcomes

Abstract

Abstract Introduction Pelvic exenterations are the standard of care for anterior urogenital invasion from advanced rectal cancers. In select cases, bladder preservation is possible. The present study aims to report the surgical and short-term oncological outcomes for the largest series of robotic bladder-sparing exenterations for locally-advanced rectal cancers. Methods Single-centre, retrospective analysis of patients that underwent robotic bladder-sparing exenterations for primary advanced rectal cancers between December 2019 and November 2022. Primary outcomes were major morbidity rate (≥ grade IIIA), R0 resections, and local recurrences. Results Sixteen patients underwent robotic bladder-sparing exenterations. The median hospital stay was 8.5 days and six patients (38%) experienced grade IIIA or more morbidity. There was no operative mortality. Five patients had a urinary leak; four from the bladder neck and one from the posterior wall of the bladder secondary to necrosis. A pathologically involved circumferential margin was observed in one patient and one patient had a local recurrence. Conclusions Robotic bladder-sparing exenterations are technically feasible for select locally-advanced rectal cancers with prostatic or urethral invasion. Operative morbidity is largely related to bladder neck leaks. Short-term oncological outcomes appear favourable in terms of R0 resections and local recurrence rates.