Oncological and functional outcomes and complications of robotic intracorporeal Studer orthotopic neobladder: A single-center retrospective study.

Abstract

Background: Robotic intracorporeal Studer orthotopic neobladder (RISON) is a complex procedure for bladder reconstruction.

Objective: This study aimed to retrospectively examine the oncological/functional outcomes, and complications of RISON at a single center.

Methods: Baseline data and perioperative results of patients who received RISON between March 2018 and December 2022 were analyzed. Sixty-two cases (60 males, 2 females), with a mean age of 56.79 ± 9.12 years, were included in the study. Follow-up data regarding RISON's therapeutic effects, including tumor outcomes, neobladder capacity, continence, and complications, were collected.

Results: All patients underwent the procedure without conversion to open surgery or changes in urinary diversion. The mean operative time lasted 379.2 ± 88.8 min, with a median blood loss of 200 mL (range: 100-300 mL). Indwelling time of the Ryles tube was 3.78 ± 2.23 days, and post-operative hospital stay was 10 days (range: 8-12 days). Pathological examination showed 87.1% (54/62) of cases had T2N0M0 tumors. A mean of 17.42 ± 8.03 lymph nodes were dissected, with three cases developing lymph node metastasis. Short-term complications (within 30 days) occurred in 51.9% of patients, while long-term complications (after 30 days) were found in 51.9% of patients. The mean neobladder volume measured 344.31 ± 147.00 mL. Daytime continence was achieved in 88.2% of patients, and night-time continence was attained in 39.2%. The average night-time urinary frequency was 2.78 ± 1.55 times, with 1.9 urine pads used on average. Follow-up duration ranged from 27 to 73 months, with a median time of 52.5 months. Five patients died of tumor metastasis, spreading to bone, liver, lung, brain, or lymph nodes. The 36- and 60-month cumulative recurrence-free survival rates were 96.3% and 87.4%, respectively. The 36- and 60-month cumulative overall survival rates were 96.3% and 90.4%, respectively.

Conclusion: Clinically, RISON is a safe and feasible procedure with excellent oncological and functional outcomes, showing promise for widespread application.