Complications from robot-assisted radical cystectomy: Where do we stand?
Por:
Guiote, I, Gaya, JM, Gausa, L, Rodriguez, O, Palou, J
Publicada:
1 mar 2016
Resumen:
Introduction: Radical cystectomy with extended lymphadenectomy is the surgical treatment of choice for muscle-invasive bladder cancer. The technical and technological improvements and the positive results from robot-assisted kidney and prostate surgery have led to the progressive development of robot-assisted radical cystectomy (RARC). We provide a global structured overview and an update on the complications of RARC, recorded according to the Clavien-Dindo classification system.
Acquisition of evidence: We conducted a search on PubMed of all publications on RARC to date (2014). Of the 259 publications found, we excluded review articles and cost analyses, publications with less than 30 cases, updates of previous studies and those whose main objective was the study of other issues related to RARC other than complications, leaving a total of 38 articles for the final analysis.
Summary of the evidence: The most common complications associated with RARC are gastrointestinal, infectious and genitourinary system, mainly Clavien 1-2, followed by Clavien 3-4. RARC had lower overall complication rates than open radical cystectomy and laparoscopic radical cystectomy and had a lower incidence of severe complications, less intraoperative bleeding and better postoperative recovery.
Conclusions: Although further scientific evidence is needed, RARC is an increasingly widespread technique that appears to reduce complications as well as the need for transfusion, and it improves recovery times. (C) 2015 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Guiote, I:
Univ Autonoma Barcelona, Serv Urol, Fundacio Puigvert, E-08193 Barcelona, Spain
Gaya, JM:
Univ Autonoma Barcelona, Serv Urol, Fundacio Puigvert, E-08193 Barcelona, Spain
Gausa, L:
Univ Autonoma Barcelona, Serv Urol, Fundacio Puigvert, E-08193 Barcelona, Spain
Rodriguez, O:
Univ Autonoma Barcelona, Serv Urol, Fundacio Puigvert, E-08193 Barcelona, Spain
Palou, J:
Univ Autonoma Barcelona, Serv Urol, Fundacio Puigvert, E-08193 Barcelona, Spain
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