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Related Experiment Videos

The lymph node yield during robot-assisted radical cystectomy.

Khurshid A Guru1, Kevan Sternberg, Gregory E Wilding

  • 1Department of Urologic Oncology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.khurshid.guru@roswellpark.org

BJU International
|March 8, 2008
PubMed
Summary
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Robot-assisted radical cystectomy (RC) with pelvic lymph node dissection (LND) is safe and effective. Lymph node yield increases with surgeon experience, demonstrating oncologically acceptable results.

Area of Science:

  • Urology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Robot-assisted radical cystectomy (RC) is increasingly utilized for bladder cancer treatment.
  • Concerns exist regarding the adequacy of pelvic lymph node dissection (LND) during robotic procedures, particularly for surgeons early in their experience.

Purpose of the Study:

  • To evaluate the lymph node yield (LNY) achieved during robot-assisted radical cystectomy (RC).
  • To assess the safety and oncological acceptability of pelvic lymph node dissection (LND) in the context of robotic assistance.

Main Methods:

  • A prospective analysis of 67 consecutive patients undergoing robot-assisted RC and LND with open urinary diversion.
  • Patients were grouped to examine the learning curve and factors influencing LNY, including body mass index (BMI) and prior surgery.

Related Experiment Videos

  • Nonlinear regression was used to analyze the LNY curve.

    • Main Results:

    • The mean LNY was 18 lymph nodes (range 6-43).
    • Mean operative duration for pelvic LND was 44 minutes.
    • Neither BMI nor previous major abdominal surgery significantly impacted LNY. One postoperative complication required exploration for vascular injury.

    Conclusions:

    • Robot-assisted RC with pelvic LND can be performed safely.
    • The lymph node yield is oncologically acceptable and demonstrates improvement with surgical experience.