OBJECTIVE: To analyze the early complications of robotic-assisted laparoscopic radical cystectomy (RARC) with extracorporeal ileal conduit or orthotopic (Studer) bladder reconstruction using the Clavien Classification, the management of these complications, and possible preventive measures. MATERIALS AND METHODS: Detailed data on all patients undergoing RARC were recorded prospectively on an encrypted database, including intraoperative or postoperative complications within 90 days of surgery. Outcome data during follow-up of up to 4 years was also collected prospectively. RESULTS: A total of 50 patients (M:F 44:6) underwent RARC and extracorporeal ileal conduit urinary diversion (n = 45) or orthotopic bladder reconstruction (n = 5) between 2004 and 2008. The overall perioperative complication rate was 17 of 50 (34%), including 3 (6%) Clavien I, 9 (18%) Clavien II, and 5 (10%) Clavien III. Final histology showed 9 (18%) patients had no residual disease pT0, 7 (14%) pTa, 11 (22%) pT1, 9 (18%) pT2, 11 (22%) pT3, and 3 (6%) pT4. CONCLUSION: Radical cystectomy remains a complex and morbid procedure with significant complication rate regardless of surgical approach. Using the Clavien reporting system, we identified early complications in 34% of patients, of which five required a significant intervention. Use of this standardized reporting system has allowed us to stratify complications after RARC, allowing easy comparison to other techniques and targeting further reductions in the future.
OBJECTIVE: To analyze the early complications of robotic-assisted laparoscopic radical cystectomy (RARC) with extracorporeal ileal conduit or orthotopic (Studer) bladder reconstruction using the Clavien Classification, the management of these complications, and possible preventive measures. MATERIALS AND METHODS: Detailed data on all patients undergoing RARC were recorded prospectively on an encrypted database, including intraoperative or postoperative complications within 90 days of surgery. Outcome data during follow-up of up to 4 years was also collected prospectively. RESULTS: A total of 50 patients (M:F 44:6) underwent RARC and extracorporeal ileal conduit urinary diversion (n = 45) or orthotopic bladder reconstruction (n = 5) between 2004 and 2008. The overall perioperative complication rate was 17 of 50 (34%), including 3 (6%) Clavien I, 9 (18%) Clavien II, and 5 (10%) Clavien III. Final histology showed 9 (18%) patients had no residual disease pT0, 7 (14%) pTa, 11 (22%) pT1, 9 (18%) pT2, 11 (22%) pT3, and 3 (6%) pT4. CONCLUSION: Radical cystectomy remains a complex and morbid procedure with significant complication rate regardless of surgical approach. Using the Clavien reporting system, we identified early complications in 34% of patients, of which five required a significant intervention. Use of this standardized reporting system has allowed us to stratify complications after RARC, allowing easy comparison to other techniques and targeting further reductions in the future.
Authors: Karthik Tanneru; Seyed Behzad Jazayeri; Jatinder Kumar; Muhammad Umar Alam; Daniel Norez; Sabine Nguyen; Soroush Bazargani; Hariharan Palayapalayam Ganapathi; Mark Bandyk; Robert Marino; Shahriar Koochekpour; Shiva Gautam; K C Balaji; Joseph Costa Journal: J Robot Surg Date: 2020-11-22
Authors: Simone Albisinni; Marco Oderda; Laurent Fossion; Virginia Varca; Jens Rassweiler; Xavier Cathelineau; Piotr Chlosta; Alexandre De la Taille; Franco Gaboardi; Thierry Piechaud; Peter Rimington; Laurent Salomon; Rafael Sanchez-Salas; Jens-Uwe Stolzenburg; Dogu Teber; Roland Van Velthoven Journal: World J Urol Date: 2015-07-02 Impact factor: 4.226
Authors: Bernard H Bochner; Guido Dalbagni; Daniel D Sjoberg; Jonathan Silberstein; Gal E Keren Paz; S Machele Donat; Jonathan A Coleman; Sheila Mathew; Andrew Vickers; Geoffrey C Schnorr; Michael A Feuerstein; Bruce Rapkin; Raul O Parra; Harry W Herr; Vincent P Laudone Journal: Eur Urol Date: 2014-12-08 Impact factor: 20.096
Authors: Angela B Smith; Michael E Woods; Mathew C Raynor; Matthew E Nielsen; Eric M Wallen; Raj S Pruthi Journal: World J Urol Date: 2012-12-27 Impact factor: 4.226