MP52-19 ROBOTIC VERSUS OPEN CYSTECTOMY WITH ILEAL CONDUIT FOR THE MANAGEMENT OF NEUROGENIC BLADDER: A COMPARATIVE STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP52-19 ROBOTIC VERSUS OPEN CYSTECTOMY WITH ILEAL CONDUIT FOR THE MANAGEMENT OF NEUROGENIC BLADDER: A COMPARATIVE STUDY Jeanne Beirnaert, Ugo Pinar, Davy Benarroche, Morgan Roupret, Véronique Phé, Christophe Vaessen, Jerome Parra, Emmanuel Chartier-Kastler, and Thomas Seisen Jeanne BeirnaertJeanne Beirnaert More articles by this author , Ugo PinarUgo Pinar More articles by this author , Davy BenarrocheDavy Benarroche More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Véronique PhéVéronique Phé More articles by this author , Christophe VaessenChristophe Vaessen More articles by this author , Jerome ParraJerome Parra More articles by this author , Emmanuel Chartier-KastlerEmmanuel Chartier-Kastler More articles by this author , and Thomas SeisenThomas Seisen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cystectomy associated with non-continent ileal diversion is a common surgery in patients with neurogenic bladder. Few data are available, especially for the robotic approach. Our purpose was to compare open cystectomy (OC) and robot-assisted radical cystectomy (RARC) with ileal conduit, regarding peri- and postoperative outcomes. METHODS: We included each patient who underwent cystectomy and ileal conduit for neurogenic bladder in a referral-center between January 2017 and November 2021. Datas were retrospectively analysed. Median follow-up was 16.6 months [IQR: 5; 41]. All patients had neurogenic bladder with failure of conservative treatment and/or impacted Quality of Life (QoL). Open cystectomy with non-continent ileal diversion and robot-assisted cystectomy with intra-corporeal non-continent ileal diversion were compared. Primary endpoint were postoperative complications. Secondary endpoints were length of hospital stay (LOS), surgery duration, blood loss and ureteral anastomosis stricture. RESULTS: A total of 123 patients were included, 85 (69.1%) undergoing OC and 38 (30.9%) RARC. Significant differences were observed for: operative time (OC: 266.9±64 vs. RARC: 205.8±55.5 min, p<0.001), blood loss (OC: 737.7±515.8 vs. RARC: 245.8±169.6 ml, p<0.001), delay until feeding resumption (OC: 7.1±4.7 vs. RARC: 5.5±2.9 days, p=0.05) and mean LOS (OC: 21.6±13.9 vs. RARC: 16.2±7.6 days, p=0.03). In RARC group, there were 10.5% complications Clavien-Dindo >2 whereas 23.8% complications underwent in the OC group (p=0.1). With regards to uretero-ileal anastomosis stenosis, 23 (18.7%) events occurred after a median follow-up of 16.6 months [IQR: 5; 41] including 20 (23.5%) and three (7.9%) in the ORC and RARC groups, respectively (p=0.07). Patients who underwent RARC had better ureteral stenosis-free survival rates than those who underwent ORC (log-rank test, p=0.05). CONCLUSIONS: RARC is a safe approach for management of neurological bladder showing significantly better perioperative outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e710 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeanne Beirnaert More articles by this author Ugo Pinar More articles by this author Davy Benarroche More articles by this author Morgan Roupret More articles by this author Véronique Phé More articles by this author Christophe Vaessen More articles by this author Jerome Parra More articles by this author Emmanuel Chartier-Kastler More articles by this author Thomas Seisen More articles by this author Expand All Advertisement PDF downloadLoading ...