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Robot-assisted radical cystectomy with neobladder diversion in females:Safety profile and functional outcomes

Asian Journal of Urology 2024年第4期11卷 618-624页

作者： Andrea Pacchetti Alberto Caviglia Vito Lorusso Nicolas Branger Thomas Maubon Stanislas Rybikowski Davide Perri Giorgio Bozzini geraldine pignot Jochen Walz Division of Urology Sant'Anna HospitalSan Fermo della BattagliaComoItaly Department of Urology ASST Grande Ospedale Metropolitano NiguardaMilanItaly Division of Urology ASST Fatebenefratelli SaccoMilanItaly Department of Urology Institut Paoli-Calmettes Cancer CentreMarseilleFrance

Objective: Radical cystectomy(RC)is a standard treatment for localized muscle invasive bladder cancer and high-risk or very high-risk non-muscle invasive bladder cancer not responding to adequate endovesical *** women,traditionally RC is performed with hystero-adnexectomy and resection of the anterior vaginal wall,often resulting in sexual ***-sparing techniques have been developed to improve functional *** present study explores the safety and the functional outcome of vaginal-sparing ***: We retrospectively analyzed all consecutive female patients undergoing robot-assisted RC(RARC)with neobladder diversion between October 2017 and February *** indications for vaginal-sparing RC were absence of tumor on bladder neck or urethra and no sign of infiltration of posterior bladder wall at the preoperative *** results were evaluated with the aid of five questions out of the Bladder Cancer Index *** were reported according to the Clavien–Dindo classification and cancer control was evaluated by recurrence-free and cancer-specific ***: A total of 22 female patients underwent RARC with neobladder *** chemotherapy was given in 17(77%)***–Dindo grades III–IV complications occurred in four(18%)*** a mean follow-up of 29(interquartile range 16–44)months,six(27.3%)patients developed distant metastases,and one(4.5%)woman loco-regional ***-sparing surgery was performed in 19(86%)patients,and in the others the anterior vaginal wall was resected,but neobladder was still *** daytime,no patients reported total incontinence and 73%(11/15)reported total continence or only occasional *** results showed that seven of 15(47%)women regained sexual activity after surgery,with a quality reported as“good”or“very good”in 40%of all 19 ***: RARC in female with anterior vaginal wall preservation is *** approach sh

关键词： Sexual-sparing Robot-assisted radical cystectomy Female Functional outcome Continence Sexual function

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