Jonathan J Melquist1, Grant Redrow1, Scott Delacroix2, Andrew Park1, Eliney E Faria3, Jose A Karam1, Surena F Matin4. 1. Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX. 2. Department of Urology, Louisiana State University, New Orleans, LA. 3. Department of Urology, Barretos Cancer Hospital, Barretos, Brazil. 4. Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: surmatin@mdanderson.org.
Abstract
OBJECTIVE: To compare the results of traditional laparoscopy and a simple, single-docking robotic approach for retroperitoneal lymph node dissection (RPLND), nephroureterectomy, and bladder cuff excision. MATERIALS AND METHODS: We evaluated 63 and 37 consecutive patients who underwent laparoscopic and robotic nephrouretectomy with RPLND, respectively, for upper-tract urothelial carcinoma (UTUC). RESULTS: Our robotic approach was associated with improved lymph node procurement (21.0 nodes [interquartile range 16.0-30.0]) when compared with laparoscopy (11.0 nodes [interquartile range 5.5-21.0]) (P < .0001). Major blood loss as defined by requiring a blood transfusion was less for the robotic group than for the laparoscopic cohort (8% vs 30%) (P = .012). In contrast, the robotic group had longer operative times (5.1 vs 3.9 hours) (P = .0001) and longer hospital stays (5.0 vs 4.0 days) (P = .0002). CONCLUSION: Our single-docking robotic technique for concomitant RPLND during nephrouretectomy is associated with improved lymph node yield.
OBJECTIVE: To compare the results of traditional laparoscopy and a simple, single-docking robotic approach for retroperitoneal lymph node dissection (RPLND), nephroureterectomy, and bladder cuff excision. MATERIALS AND METHODS: We evaluated 63 and 37 consecutive patients who underwent laparoscopic and robotic nephrouretectomy with RPLND, respectively, for upper-tract urothelial carcinoma (UTUC). RESULTS: Our robotic approach was associated with improved lymph node procurement (21.0 nodes [interquartile range 16.0-30.0]) when compared with laparoscopy (11.0 nodes [interquartile range 5.5-21.0]) (P < .0001). Major blood loss as defined by requiring a blood transfusion was less for the robotic group than for the laparoscopic cohort (8% vs 30%) (P = .012). In contrast, the robotic group had longer operative times (5.1 vs 3.9 hours) (P = .0001) and longer hospital stays (5.0 vs 4.0 days) (P = .0002). CONCLUSION: Our single-docking robotic technique for concomitant RPLND during nephrouretectomy is associated with improved lymph node yield.
Authors: Thomas Stonier; Nick Simson; Su-Min Lee; Ian Robertson; Tarik Amer; Bhaskar K Somani; Bhavan P Rai; Omar Aboumarzouk Journal: Arab J Urol Date: 2017-06-16