Single-center experience of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Bladder cancer necessitates aggressive treatment, often involving radical cystectomy and pelvic lymph node dissection.
• Minimally invasive approaches like robot-assisted radical cystectomy (RARC) aim to improve patient outcomes and reduce surgical morbidity.

Purpose of the Study:

• To evaluate the outcomes of robot-assisted radical cystectomy (RARC) combined with extended pelvic lymph node dissection (ePLND) for bladder cancer patients.
• To assess the safety, surgical, and oncologic results of this combined approach.

Main Methods:

• A retrospective study included 57 patients undergoing RARC and ePLND between October 2016 and June 2019.
• Data collected included patient demographics, operative details, pathological findings, and postoperative complications.
• Exclusion criteria involved prior pelvic surgery, radiation, or incomplete data.

Main Results:

• The mean patient age was 64.7 years, with a mean operative time of 418.6 minutes and estimated blood loss of 313 mL.
• Pathological stages ranged from pT0 to pT4b, with a mean lymph node yield of 23.45 and 16% positive nodes.
• Overall complication rates were 31.6% minor and 15.8% major in the early period, and 7.0% minor and 8.8% major in the late period.

Conclusions:

• Robot-assisted radical cystectomy (RARC) with extended pelvic lymph node dissection (ePLND) is a complex yet safe procedure.
• The approach yields acceptable morbidity and excellent surgical and oncologic outcomes for muscle-invasive or high-risk bladder tumors.