MP03-01 ROBOT-ASSISTED RADICAL CYSTECTOMY WITH EXTRACORPOREAL URINARY DIVERSION DOES NOT INCREASE URETEROENTERIC STRICTURE RATE: OUTCOMES FROM A RANDOMIZED TRIAL COMPARING OPEN VERSUS ROBOTIC CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022MP03-01 ROBOT-ASSISTED RADICAL CYSTECTOMY WITH EXTRACORPOREAL URINARY DIVERSION DOES NOT INCREASE URETEROENTERIC STRICTURE RATE: OUTCOMES FROM A RANDOMIZED TRIAL COMPARING OPEN VERSUS ROBOTIC CYSTECTOMY Chun Huang, Melissa Assel, Benjamin Beech, Nicole Benfante, Daniel Sjoberg, Jonathan Coleman, Guido Dalbagni, Harry Herr, S. Machele Donat, Vincent Laudone, Andrew Vickers, Bernard Bochner, and Alvin Goh Chun HuangChun Huang More articles by this author , Melissa AsselMelissa Assel More articles by this author , Benjamin BeechBenjamin Beech More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , Harry HerrHarry Herr More articles by this author , S. Machele DonatS. Machele Donat More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Andrew VickersAndrew Vickers More articles by this author , Bernard BochnerBernard Bochner More articles by this author , and Alvin GohAlvin Goh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002515.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted radical cystectomy is increasingly used to treat bladder cancer. There have been reports of higher stricture risks compared to open cystectomy. We analyzed stricture risk in patients randomized to open or robotic cystectomy with extracorporeal urinary diversion. METHODS: We included 118 patients randomized to robotic (n=60) or open (n=58) cystectomy at a single, high-volume institution. Urinary diversion was performed by experienced open surgeons. Stricture was defined as non-malignant obstruction on imaging, corroborated by clinical status, and requiring procedural intervention. The risk of stricture within 1 year was compared between groups using Fisher’s exact test. RESULTS: Fifty-eight and 60 patients were randomized to robotic and open cystectomy, respectively. We identified 5 strictures, all in the open group. In patients with at least 1 year of follow-up, the increase in risk of stricture from open surgery was 9.3% (95% CI 1.5%, 17%). Of the 5 strictures, 3 were managed endoscopically while 2 required open revision. There was no evidence that perioperative grade 3-5 complication were associated with development of a stricture (p=1) and no evidence of a difference in 24-month estimated glomerular filtration rate between arms (p=0.15). CONCLUSIONS: In this study at a high volume center, robotic cystectomy with extracorporeal urinary diversion achieved excellent ureteral anastomotic outcomes. Although stricture risk was higher in the open group, risk was low in both arms. Purported increased risk of stricture is not a reason to avoid the robot-assisted radical cystectomy. Future research should examine the impact of different surgical techniques and operator experience on the risk of stricture, especially as more intracorporeal diversions are performed. Source of Funding: This study was supported in part by the Sidney Kimmel Center for Prostate and Urologic Cancers at Memorial Sloan Kettering Cancer Center (MSK), Pin Down Bladder Cancer, the Michael and Zena Wiener Research and Therapeutics Program in Bladder Cancer, and a Cancer Center Support Grant (P30 CA008748) to MSK from the National Institutes of Health/National Cancer Institute © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e19 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chun Huang More articles by this author Melissa Assel More articles by this author Benjamin Beech More articles by this author Nicole Benfante More articles by this author Daniel Sjoberg More articles by this author Jonathan Coleman More articles by this author Guido Dalbagni More articles by this author Harry Herr More articles by this author S. Machele Donat More articles by this author Vincent Laudone More articles by this author Andrew Vickers More articles by this author Bernard Bochner More articles by this author Alvin Goh More articles by this author Expand All Advertisement PDF DownloadLoading ...