Fiche publication
Date publication
avril 2024
Journal
The French journal of urology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr LANG Hervé
,
Dr TRICARD Thibault
Tous les auteurs :
Tomos G, Saussine C, Gaillard V, Lang H, Tricard T
Lien Pubmed
Résumé
Objective : To assess the short-term functional outcomes and morbidity of robotic-assisted cystectomy (RAC) and intracorporeal urinary diversion (ICUD) in patients with lower urinary tract dysfunction (LUTD). Methods : All consecutive patients who underwent RAC+ICUD for LUTD in a tertiary hospital center, between July 2018 and May 2021 were retrospectively included. Medical records were systematically reviewed and patient, perioperative and postoperative data were collected. A good short-term functional outcome was defined by the combination of a satisfying urostomy equipment (absence of urine leakage and easy appliance of the urostomy bag), the absence of pelvicaliceal system dilatation on sonography, and the absence of renal function decrease at the 2 months post-operative consultation. Intraoperative parameters and post-operative complications were collected to assess morbidity. Results : Thirty-five patients were included. Eight (22.8%) patients needed intraoperative conversion to laparotomy. Twenty-five patients (92,5%) met criteria for a good functional outcome 2 months post-operatively. The median operative time was 346min (86.5-407.5). The median blood loss was 100mL (100-290) and 5 patients (18.5%) required blood transfusion. The median times to return of bowel function was 3 days (2-4) and the median length of hospital stay was 10 days (10-18). Peri-operative complications were reported in 16 patients (59.2%): 6 (22.2%) minor complications Clavien ≤ II and 10 (37%) major complications Clavien ≥ III. There was no significative decrease of the renal function (mean preoperative creatininemia of 61.2µmol/L (50.5-74.5) vs 64.5µmol/L (47-85.25) postoperatively) Conclusion : RAC+ICUD in LUTD can provide good short-term functional outcomes while limiting blood transfusion, time to return of bowel function and the length of hospital stay. These results should be confirmed by larger prospective study.
Mots clés
cystectomie, cystectomy, dysfonction du bas appareil urinaire, dérivation urinaire non continente, intracorporeal urinary diversion, laparoscopie robot assistée, lower urinary tract dysfunction, neurogenic bladder, robot-assisted cystectomy, vessie neurologique
Référence
Fr J Urol. 2024 04 16;:102639
