Skip to main content
Erschienen in: World Journal of Urology 3/2013

01.06.2013 | Topic paper

Prevention and management of complications following robot-assisted radical cystectomy: lessons learned after >250 consecutive cases

verfasst von: Angela B. Smith, Michael E. Woods, Mathew C. Raynor, Matthew E. Nielsen, Eric M. Wallen, Raj S. Pruthi

Erschienen in: World Journal of Urology | Ausgabe 3/2013

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Numerous case series of robot-assisted radical cystectomy have emerged which describe complication rates comparable to open series. However, various reports have outlined preoperative factors as predictors of postoperative complications. Understanding these factors and the methods to optimize the perioperative care of the robotic cystectomy patient is essential for successful outcomes.

Methods

In this topic paper, we briefly review the literature surrounding complication rates following robot-assisted radical cystectomy as well as describe our experience after >250 cases, outlining our suggestions for avoidance of surgical complications when building a practice that incorporates this technique.

Results

Due to numerous variables, there are a number of intra-operative considerations, including patient selection, perioperative care pathway, intra-operative technique, and equipment choice that we have found to decrease post-operative complications and improve patient outcomes.

Conclusion

Through careful patient selection, use of appropriate equipment and perioperative surgical management, robotic cystectomy is a feasible procedure with excellent perioperative results.
Literatur
1.
Zurück zum Zitat Lowrance WT, Rumohr JA, Chang SS, Clark PE, Smith JA Jr, Cookson MS (2008) Contemporary open radical cystectomy: analysis of perioperative outcomes. J Urol 179:1313–1318 discussion 8PubMedCrossRef Lowrance WT, Rumohr JA, Chang SS, Clark PE, Smith JA Jr, Cookson MS (2008) Contemporary open radical cystectomy: analysis of perioperative outcomes. J Urol 179:1313–1318 discussion 8PubMedCrossRef
2.
Zurück zum Zitat Parra RO, Andrus CH, Jones JP, Boullier JA (1992) Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol 148:1140–1144PubMed Parra RO, Andrus CH, Jones JP, Boullier JA (1992) Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol 148:1140–1144PubMed
3.
Zurück zum Zitat Shabsigh A, Korets R, Vora KC et al (2009) Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 55:164–174PubMedCrossRef Shabsigh A, Korets R, Vora KC et al (2009) Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 55:164–174PubMedCrossRef
4.
Zurück zum Zitat Kauffman EC, Ng CK, Lee MM et al (2010) Critical analysis of complications after robotic-assisted radical cystectomy with identification of preoperative and operative risk factors. BJU Int 105:520–527PubMedCrossRef Kauffman EC, Ng CK, Lee MM et al (2010) Critical analysis of complications after robotic-assisted radical cystectomy with identification of preoperative and operative risk factors. BJU Int 105:520–527PubMedCrossRef
5.
Zurück zum Zitat Treiyer A, Saar M, Kopper B, Kamradt J, Siemer S, Stockle M (2011) Robotic-assisted laparoscopic radical cystectomy: evaluation of functional and oncological results. Actas Urol Esp 35:152–157PubMedCrossRef Treiyer A, Saar M, Kopper B, Kamradt J, Siemer S, Stockle M (2011) Robotic-assisted laparoscopic radical cystectomy: evaluation of functional and oncological results. Actas Urol Esp 35:152–157PubMedCrossRef
6.
Zurück zum Zitat Khan MS, Elhage O, Challacombe B, Rimington P, Murphy D, Dasgupta P (2011) Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system. Urology 77:357–362PubMedCrossRef Khan MS, Elhage O, Challacombe B, Rimington P, Murphy D, Dasgupta P (2011) Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system. Urology 77:357–362PubMedCrossRef
7.
Zurück zum Zitat Hayn MH, Hellenthal NJ, Hussain A, Stegemann AP, Guru KA (2011) Defining morbidity of robot-assisted radical cystectomy using a standardized reporting methodology. Eur Urol 59:213–218PubMedCrossRef Hayn MH, Hellenthal NJ, Hussain A, Stegemann AP, Guru KA (2011) Defining morbidity of robot-assisted radical cystectomy using a standardized reporting methodology. Eur Urol 59:213–218PubMedCrossRef
8.
Zurück zum Zitat Pruthi RS, Nielsen ME, Nix J, Smith A, Schultz H, Wallen EM (2010) Robotic radical cystectomy for bladder cancer: surgical and pathological outcomes in 100 consecutive cases. J Urol 183:510–514PubMedCrossRef Pruthi RS, Nielsen ME, Nix J, Smith A, Schultz H, Wallen EM (2010) Robotic radical cystectomy for bladder cancer: surgical and pathological outcomes in 100 consecutive cases. J Urol 183:510–514PubMedCrossRef
9.
Zurück zum Zitat Ng CK, Kauffman EC, Lee MM et al (2010) A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol 57:274–281PubMedCrossRef Ng CK, Kauffman EC, Lee MM et al (2010) A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol 57:274–281PubMedCrossRef
10.
Zurück zum Zitat Yu HY, Hevelone ND, Lipsitz SR et al (2012) Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample. Eur Urol 61:1239–1244PubMedCrossRef Yu HY, Hevelone ND, Lipsitz SR et al (2012) Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample. Eur Urol 61:1239–1244PubMedCrossRef
11.
Zurück zum Zitat Styn NR, Montgomery JS, Wood DP et al (2012) Matched comparison of robotic-assisted and open radical cystectomy. Urology 79:1303–1308PubMedCrossRef Styn NR, Montgomery JS, Wood DP et al (2012) Matched comparison of robotic-assisted and open radical cystectomy. Urology 79:1303–1308PubMedCrossRef
12.
Zurück zum Zitat Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS (2010) Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol 57:196–201PubMedCrossRef Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS (2010) Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol 57:196–201PubMedCrossRef
13.
Zurück zum Zitat Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R (2012) Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol [Epub ahead of print] Parekh DJ, Messer J, Fitzgerald J, Ercole B, Svatek R (2012) Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol [Epub ahead of print]
14.
Zurück zum Zitat Butt ZM, Fazili A, Tan W et al (2009) Does the presence of significant risk factors affect perioperative outcomes after robot-assisted radical cystectomy? BJU Int 104:986–990PubMedCrossRef Butt ZM, Fazili A, Tan W et al (2009) Does the presence of significant risk factors affect perioperative outcomes after robot-assisted radical cystectomy? BJU Int 104:986–990PubMedCrossRef
15.
Zurück zum Zitat Knox ML, El-Galley R, Busby JE (2012) Robotic versus open radical cystectomy: identification of patients who benefit from the robotic approach. J Endourol [Epub ahead of print] Knox ML, El-Galley R, Busby JE (2012) Robotic versus open radical cystectomy: identification of patients who benefit from the robotic approach. J Endourol [Epub ahead of print]
16.
Zurück zum Zitat Smith AB, Raynor M, Amling CL et al (2012) Multi-institutional analysis of robotic radical cystectomy for bladder cancer: perioperative outcomes and complications in 227 patients. J Laparoendosc Adv Surg Tech A 22:17–21PubMedCrossRef Smith AB, Raynor M, Amling CL et al (2012) Multi-institutional analysis of robotic radical cystectomy for bladder cancer: perioperative outcomes and complications in 227 patients. J Laparoendosc Adv Surg Tech A 22:17–21PubMedCrossRef
17.
Zurück zum Zitat Pruthi RS, Smith A, Wallen EM (2008) Evaluating the learning curve for robot-assisted laparoscopic radical cystectomy. J Endourol 22:2469–2474PubMedCrossRef Pruthi RS, Smith A, Wallen EM (2008) Evaluating the learning curve for robot-assisted laparoscopic radical cystectomy. J Endourol 22:2469–2474PubMedCrossRef
18.
Zurück zum Zitat Hayn MH, Hellenthal NJ, Seixas-Mikelus SA et al (2011) Is patient outcome compromised during the initial experience with robot-assisted radical cystectomy? Results of 164 consecutive cases. BJUI Int 108(6):882–887 Hayn MH, Hellenthal NJ, Seixas-Mikelus SA et al (2011) Is patient outcome compromised during the initial experience with robot-assisted radical cystectomy? Results of 164 consecutive cases. BJUI Int 108(6):882–887
19.
Zurück zum Zitat Richards KA, Kader K, Pettus JA, Smith JJ, Hemal AK (2011) Does initial learning curve compromise outcomes for robot-assisted radical cystectomy? A critical evaluation of the first 60 cases while establishing a robotics program. J Endourol 25:1553–1558PubMedCrossRef Richards KA, Kader K, Pettus JA, Smith JJ, Hemal AK (2011) Does initial learning curve compromise outcomes for robot-assisted radical cystectomy? A critical evaluation of the first 60 cases while establishing a robotics program. J Endourol 25:1553–1558PubMedCrossRef
20.
Zurück zum Zitat Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P (2005) Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg 92:409–414PubMedCrossRef Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P (2005) Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg 92:409–414PubMedCrossRef
21.
Zurück zum Zitat Raynor MC, Lavien G, Nielsen M, Wallen EM, Pruthi RS (2011) Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion. Urol Oncol [Epub ahead of print] Raynor MC, Lavien G, Nielsen M, Wallen EM, Pruthi RS (2011) Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion. Urol Oncol [Epub ahead of print]
22.
Zurück zum Zitat Pruthi RS, Nielsen M, Smith A, Nix J, Schultz H, Wallen EM (2010) Fast track program in patients undergoing radical cystectomy: results in 362 consecutive patients. J Am Coll Surg 210:93–99PubMedCrossRef Pruthi RS, Nielsen M, Smith A, Nix J, Schultz H, Wallen EM (2010) Fast track program in patients undergoing radical cystectomy: results in 362 consecutive patients. J Am Coll Surg 210:93–99PubMedCrossRef
23.
Zurück zum Zitat Poulsen AL, Horn T, Steven K (1998) Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall. J Urol 160:2015–2019 discussion 20PubMedCrossRef Poulsen AL, Horn T, Steven K (1998) Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall. J Urol 160:2015–2019 discussion 20PubMedCrossRef
24.
Zurück zum Zitat Davis JW, Gaston K, Anderson R et al (2011) Robot assisted extended pelvic lymphadenectomy at radical cystectomy: lymph node yield compared with second look open dissection. J Urol 185:79–83PubMedCrossRef Davis JW, Gaston K, Anderson R et al (2011) Robot assisted extended pelvic lymphadenectomy at radical cystectomy: lymph node yield compared with second look open dissection. J Urol 185:79–83PubMedCrossRef
25.
Zurück zum Zitat Lavery HJ, Martinez-Suarez HJ, Abaza R (2011) Robotic extended pelvic lymphadenectomy for bladder cancer with increased nodal yield. BJU Int 107:1802–1805PubMedCrossRef Lavery HJ, Martinez-Suarez HJ, Abaza R (2011) Robotic extended pelvic lymphadenectomy for bladder cancer with increased nodal yield. BJU Int 107:1802–1805PubMedCrossRef
Metadaten
Titel
Prevention and management of complications following robot-assisted radical cystectomy: lessons learned after >250 consecutive cases
verfasst von
Angela B. Smith
Michael E. Woods
Mathew C. Raynor
Matthew E. Nielsen
Eric M. Wallen
Raj S. Pruthi
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 3/2013
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-012-1007-x

Weitere Artikel der Ausgabe 3/2013

World Journal of Urology 3/2013 Zur Ausgabe

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.