Robot-Assisted Laparoscopic Management of Bladder/Prostate Rhabdomyosarcoma in Children: Initial Series and 1-Year Outcomes.

Abstract

Objective: To present our preliminary experiences of robot-assisted laparoscopic radical or partial cystectomy for bladder/prostate rhabdomyosarcoma (B/P RMS) in children. Methods: A retrospective study was conducted with children who underwent robot-assisted laparoscopic surgery for B/P RMS between July 2018 and March 2020 under the approval of IRB of our center. The patient characteristics, tumor position, perioperative information, short time oncologic survival outcomes, and urinary function were recorded and evaluated. Results: We identified eight children who underwent robot-assisted laparoscopic surgery for B/P RMS. Partial cystectomy was performed on all, but one, patients, who underwent radical cystectomy and sigmoid neobladder reconstruction. Preoperative chemotherapy was administered to all eight patients, while preoperative radiotherapy was conducted in three cases, including one patient with a history of pelvic RMS. Unilateral/bilateral ureteral reimplantation was done in four cases in which the patients' ureteral orifices were involved. The mean follow-up time was 13.3 months, and no local recurrence or metastasis was observed. No patient experienced urinary incontinence eventually. Conclusion: Robot-assisted laparoscopic resection for bladder RMS in children is safe and feasible. Preoperative radiotherapy could decrease the tumor volume so that the membranous urethra could be preserved for as long as possible. The oncologic efficacy and the overall survival rate require further investigation and longer follow-up.