AccScience Publishing / Bladder / Online First / DOI: 10.14440/bladder.2024.0025
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RESEARCH ARTICLE

Oncological and functional outcomes and complications of robotic intracorporeal Studer orthotopic neobladder: A single-center retrospective study

Qiang Cheng1,2,3† ,  Yin Lu1,3,4† ,  Bin Jiang1,3,4† ,  Qing Ai1,3 ,  Fan Gao1,3,4 ,  Xupeng Zhao1,3,4 ,  Jinlu Tang1,2,3 ,  Yi Feng1,2,3 ,  Wenfeng Gao1,3,4 ,  Hongzhao Li1*
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1 Department of Urology, Chinese People’s Liberation Army General Hospital, Beijing 100039, China
2 Chinese People’s Liberation Army Medical School, Beijing 100853, China
3 Senior Department of Urology, The Third Medical Center of People’s Liberation Army General Hospital, Beijing 100039, China
4 School of Medicine, Nankai University, Tianjin 300071, China
Bladder, e21200029 https://doi.org/10.14440/bladder.2024.0025
Submitted: 2 August 2024 | Revised: 9 October 2024 | Accepted: 21 November 2024 | Published: 9 January 2025
© 2025 by the Bladder published by POL Scientific. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Background: Robotic intracorporeal Studer orthotopic neobladder (RISON) is a complex procedure for bladder reconstruction. Objective: This study aimed to retrospectively examine the oncological/functional outcomes, and complications of RISON at a single center. Methods: Baseline data and perioperative results of patients who received RISON between March 2018 and December 2022 were analyzed. Sixty-two cases (60 males, 2 females), with a mean age of 56.79 ± 9.12 years, were included in the study. Follow-up data regarding RISON’s therapeutic effects, including tumor outcomes, neobladder capacity, continence, and complications, were collected. Results: All patients underwent the procedure without conversion to open surgery or changes in urinary diversion. The mean operative time lasted 379.2 ± 88.8 min, with a median blood loss of 200 mL (range: 100–300 mL). Indwelling time of the Ryles tube was 3.78 ± 2.23 days, and post-operative hospital stay was 10 days (range: 8–12 days). Pathological examination showed 87.1% (54/62) of cases had T2N0M0 tumors. A mean of 17.42 ± 8.03 lymph nodes were dissected, with three cases developing lymph node metastasis. Short-term complications (within 30 days) occurred in 51.9% of patients, while long-term complications (after 30 days) were found in 51.9% of patients. The mean neobladder volume measured 344.31 ± 147.00 mL. Daytime continence was achieved in 88.2% of patients, and night-time continence was attained in 39.2%. The average night-time urinary frequency was 2.78 ± 1.55 times, with 1.9 urine pads used on average. Follow-up duration ranged from 27 to 73 months, with a median time of 52.5 months. Five patients died of tumor metastasis, spreading to bone, liver, lung, brain, or lymph nodes. The 36- and 60-month cumulative recurrence-free survival rates were 96.3% and 87.4%, respectively. The 36- and 60-month cumulative overall survival rates were 96.3% and 90.4%, respectively. Conclusion: Clinically, RISON is a safe and feasible procedure with excellent oncological and functional outcomes, showing promise for widespread application.

Keywords
Intracorporeal Studer orthotopic neobladder
Robotic surgeries
Oncologic outcomes
Functional outcomes
Complications
Funding
This work was supported by the National Key R&D Program of China (grant no. 2023YFC2507006 and 2022YFC3602900) and the Youth Independent Innovation Science Fund Support Project of People’s Liberation Army (PLA) General Hospital (grant no. 22QNFC047).
Conflict of interest
The authors declare no conflicts of interest.
References
[1]
  1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660

 

  1. Tappero S, Dell’Oglio P, Cerruto MA, et al. Ileal conduit versus orthotopic neobladder urinary diversion in robot-assisted radical cystectomy: Results from a multi-institutional series. Eur Urol Open Sci. 2023;50:47-56. doi: 10.1016/j.euros.2023.01.009

 

  1. Alfred Witjes J, Lebret T, Compérat EM, et al. Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol. 2017;71(3):462-475. doi: 10.1016/j.eururo.2016.06.020

 

  1. Lee RK, Abol-Enein H, Artibani W, et al. Urinary diversion after radical cystectomy for bladder cancer: Options, patient selection, and outcomes. BJU Int. 2014;113(1):11-23. doi: 10.1111/bju.12121

 

  1. Perimenis P, Koliopanou E. Postoperative management and rehabilitation of patients receiving an ileal orthotopic bladder substitution. Urol Nurs. 2004;24(5):383-386.

 

  1. Hussein AA, May PR, Jing Z, et al. Outcomes of intracorporeal urinary diversion after robot-assisted radical cystectomy: Results from the international robotic cystectomy consortium. J Urol. 2018;199(5):1302-1311. doi: 10.1016/j.juro.2017.12.045

 

  1. Mastroianni R, Ferriero M, Tuderti G, et al. Open radical cystectomy versus robot-assisted radical cystectomy with intracorporeal urinary diversion: Early outcomes of a single-center randomized controlled trial. J Urol. 2022;207(5):982-992. doi: 10.1097/ju.0000000000002422

 

  1. Mastroianni R, Tuderti G, Anceschi U, et al. Comparison of patient-reported health-related quality of life between open radical cystectomy and robot-assisted radical cystectomy with intracorporeal urinary diversion: Interim analysis of a randomised controlled trial. Eur Urol Focus. 2022;8(2):465-471. doi: 10.1016/j.euf.2021.03.002

 

  1. Mastroianni R, Tuderti G, Ferriero M, et al. Robot-assisted radical cystectomy with totally intracorporeal urinary diversion versus open radical cystectomy: 3-year outcomes from a randomised controlled trial. Eur Urol. 2024;85(5):422-430. doi: 10.1016/j.eururo.2024.01.018

 

  1. Cheng Q, Gu L, Chen W, et al. Nerve-spring technique could achieve a functional trifecta outcome of robotic intracorporeal studer’s orthotopic neobladder in the male. Bladder (San Franc). 2022;9(1):e50. doi: 10.14440/bladder.2022.850

 

  1. Cerantola Y, Valerio M, Persson B, et al. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS(®)) society recommendations. Clin Nutr. 2013;32(6):879-887. doi: 10.1016/j.clnu.2013.09.014

 

  1. Williams SB, Cumberbatch MGK, Kamat AM, et al. Reporting radical cystectomy outcomes following implementation of enhanced recovery after surgery protocols: A systematic review and individual patient data meta-analysis. Eur Urol. 2020;78(5):719-730. doi: 10.1016/j.eururo.2020.06.039

 

  1. Borgmann H, Cooperberg M, Murphy D, et al. Online professionalism-2018 update of european association of urology (@Uroweb) recommendations on the appropriate use of social media. Eur Urol. 2018;74(5):644-650. doi: 10.1016/j.eururo.2018.08.022

 

  1. Powles T, Bellmunt J, Comperat E, et al. Bladder cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(3):244-258. doi: 10.1016/j.annonc.2021.11.012

 

  1. Comperat E, Amin MB, Cathomas R, et al. Current best practice for bladder cancer: A narrative review of diagnostics and treatments. Lancet. 2022;400(10364):1712-1721. doi: 10.1016/S0140-6736(22)01188-6

 

  1. Check DK, Leo MC, Banegas MP, et al. Decision regret related to urinary diversion choice among patients treated with cystectomy. J Urol. 2020;203(1):159-163. doi: 10.1097/ju.0000000000000512

 

  1. Alfred Witjes J, Max Bruins H, Carrión A, et al. European association of urology guidelines on muscle-invasive and metastatic bladder cancer: Summary of the 2023 guidelines. Eur Urol. 2024;85(1):17-31. doi: 10.1016/j.eururo.2023.08.016

 

  1. Tyritzis SI, Hosseini A, Collins J, et al. Oncologic, functional, and complications outcomes of robot-assisted radical cystectomy with totally intracorporeal neobladder diversion. Eur Urol. 2013;64(5):734-741. doi: 10.1016/j.eururo.2013.05.050

 

  1. Katayama S, Mori K, Pradere B, et al. Intracorporeal versus extracorporeal urinary diversion in robot-assisted radical cystectomy: A systematic review and meta-analysis. Int J Clin Oncol. 2021;26(9):1587-1599. doi: 10.1007/s10147-021-01972-2

 

  1. Tanneru K, Jazayeri SB, Kumar J, et al. Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: A meta-analysis, cumulative analysis, and systematic review. J Robot Surg. 2021;15(3):321-333. doi: 10.1007/s11701-020-01174-4

 

  1. Mistretta FA, Musi G, Colla Ruvolo C, et al. Robot-assisted radical cystectomy for nonmetastatic urothelial carcinoma of urinary bladder: A comparison between intracorporeal versus extracorporeal orthotopic ileal neobladder. J Endourol. 2021;35(2):151-158.doi: 10.1089/end.2020.0622

 

  1. You C, Du Y, Wang H, et al. Robot-assisted radical cystectomy with intracorporeal urinary diversion: A new standard of urinary diversion. J Endourol. 2021;35(4):473-482. doi: 10.1089/end.2020.0760

 

  1. Tyritzis SI, Hosseini A, Jonsson M, Adding C, Nilsson A, Wiklund NP. Robot-assisted intracorporeal formation of the ileal neobladder. J Endourol. 2012;26(12):1570-1575. doi: 10.1089/end.2012.0424

 

  1. Chopra S, de Castro Abreu AL, Berger AK, et al. Evolution of robot-assisted orthotopic ileal neobladder formation: A step-by-step update to the University of Southern California (USC) technique. BJU Int. 2017;119(1):185-191. doi: 10.1111/bju.13611

 

  1. Tan WS, Sridhar A, Goldstraw M, et al. Robot-assisted intracorporeal pyramid neobladder. BJU Int. 2015;116(5):771-779. doi: 10.1111/bju.13189

 

  1. Asimakopoulos AD, Campagna A, Gakis G, et al. Nerve sparing, robot-assisted radical cystectomy with intracorporeal bladder substitution in the male. J Urol. 2016;196(5):1549-1557. doi: 10.1016/j.juro.2016.04.114

 

  1. Simone G, Papalia R, Misuraca L, et al. Robotic intracorporeal padua ileal bladder: Surgical technique, perioperative, oncologic and functional outcomes. Eur Urol. 2018;73(6):934-940. doi: 10.1016/j.eururo.2016.10.018

 

  1. Balbay MD, Koseoglu E, Canda AE, et al. Endopelvic fascia sparing robotic radical cystectomy with intracorporeal studer pouch with Balbay’s technique. JSLS. 2022;26(3):e2022.00031. doi: 10.4293/JSLS.2022.00031

 

  1. Piramide F, Turri F, Amparore D, et al. Atlas of intracorporeal orthotopic neobladder techniques after robot-assisted radical cystectomy and systematic review of clinical outcomes. Eur Urol. 2024;85(4):348-360. doi: 10.1016/j.eururo.2023.11.017

 

  1. Smith ZL, Christodouleas JP, Keefe SM, Malkowicz SB, Guzzo TJ. Bladder preservation in the treatment of muscle-invasive bladder cancer (MIBC): A review of the literature and a practical approach to therapy. BJU Int. 2013;112(1):13-25. doi: 10.1111/j.1464-410X.2012.11762.x

 

  1. Kim JK, Park SY, Ahn HJ, Kim CS, Cho KS. Bladder cancer: Analysis of multi-detector row helical CT enhancement pattern and accuracy in tumor detection and perivesical staging. Radiology. 2004;231(3):725-731. doi: 10.1148/radiol.2313021253

 

  1. Barentsz JO, Jager GJ, Witjes JA, Ruijs JH. Primary staging of urinary bladder carcinoma: The role of MRI and a comparison with CT. Eur Radiol. 1996;6(2):129-133. doi: 10.1007/BF00181125

 

  1. Ha HK, Koo PJ, Kim SJ. Diagnostic accuracy of F-18 FDG PET/CT for preoperative lymph node staging in newly diagnosed bladder cancer patients: A systematic review and meta-analysis. Oncology. 2018;95(1):31-38. doi: 10.1159/000488200

 

  1. Wilson TG, Guru K, Rosen RC, et al. Best practices in robot-assisted radical cystectomy and urinary reconstruction: Recommendations of the pasadena consensus panel. Eur Urol. 2015;67(3):363-375. doi: 10.1016/j.eururo.2014.12.009

 

  1. Cheng Q, Gao F, Chen WZ, et al. Analysis of CUSUM learning curve of robotic intracorporeal Studer’s orthotopic neobladder. J Minim Invasive Urol. 2023;12(06):365-369. [In Chinese]. doi: 10.19558/j.cnki.10-1020/r.2023.06.002

 

  1. Tuderti G, Mastroianni R, Brassetti A, et al. Robot-assisted radical cystectomy with intracorporeal neobladder: Impact of learning curve and long-term assessment of functional outcomes. Minerva Urol Nephrol. 2021;73(6):754-762. doi: 10.23736/S2724-6051.20.03948-X

 

  1. Wei H, Wang M, Wasilijiang W, et al. Modified ileal conduit intracorporeally accomplished following laparoscopic radical cystectomy with enhanced recovery protocols: Experience with 48 cases. Transl Androl Urol. 2021;10(4):1596-1606. doi: 10.21037/tau-20-1515

 

  1. Furrer MA, Studer UE, Gross T, Burkhard FC, Thalmann GN, Nguyen DP. Nerve-sparing radical cystectomy has a beneficial impact on urinary continence after orthotopic bladder substitution, which becomes even more apparent over time. BJU Int. 2018;121(6):935-944. doi: 10.1111/bju.14123

 

  1. Hernandez V, Espinos EL, Dunn J, et al. Oncological and functional outcomes of sexual function-preserving cystectomy compared with standard radical cystectomy in men: A systematic review. Urol Oncol. 2017;35(9):539.e17-539.e29. doi: 10.1016/j.urolonc.2017.04.013

 

  1. Kretschmer A, Grimm T, Buchner A, et al. Prognostic features for objectively defined urinary continence after radical cystectomy and ileal orthotopic neobladder in a contemporary cohort. J Urol. 2017;197(1):210-215. doi: 10.1016/j.juro.2016.08.004

 

  1. Clifford TG, Shah SH, Bazargani ST, et al. Prospective evaluation of continence following radical cystectomy and orthotopic urinary diversion using a validated questionnaire. J Urol. 2016;196(6):1685-1691. doi: 10.1016/j.juro.2016.05.093

 

  1. Satkunasivam R, Santomauro M, Chopra S, et al. Robotic intracorporeal orthotopic neobladder: Urodynamic outcomes, urinary function, and health-related quality of life. Eur Urol. 2016;69(2):247-253. doi: 10.1016/j.eururo.2015.06.041

 

  1. Benamran D, Phe V, Drouin SJ, et al. Functional outcomes obtained with intracorporeal neobladder after robotic radical cystectomy for cancer: A narrative review. J Robot Surg. 2020;14(6):813-820. doi: 10.1007/s11701-020-01070-x
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