Robot-assisted radical nephrourectomy and bladder cuff excision – A single institute experience



'''Purpose:'''  For patient with localized upper tract urothelial carcinoma, radical nephrourectomy and bladder cuff excision (RNU+BCE) was the standard treatment. In recent years, robot-assisted RNU and BCE (RaRNU+BCE) had been another choice of surgical intervention. This article was aimed to analyse the efficacy and peri-operative outcomes regarding RaRNU+BCE by this single institutional experience.      

'''Materials and Methods:'''  From March 2012 to November 2015, total 54 patients with upper tract urothelial carcinoma were treated with RaRBU+BCE at Taipei Veterans General Hospital. We collected demographic data, histopathological reports, and peri-operative complications.      

'''Results:'''  Total 54 patients were included in our study. The mean age was 71.9 ± 9.9 (range 48–88) and the mean body mass index was 23.5 ± 2.9 (range 16.4–30.8). Median operative time was 314 min. (RaRNU:133.9 ± 41.4 mins, RaBCE: 72.9 ± 25.7 mins). The first docking time was 26.8 ± 7.7 mins and the second docking time was 16.5 ± 6.7 mins. Median bleeding volume was 87.7 ml. Pathological stage distribution was 27.8%, 7.4%, 31.5%, 13.0%, 33.3% and 5.6% in pTa, pTis, pT1, pT2, pT3 and pT4, respectively. Complications occurred in 7 cases (13%), with 4 grade I and 3 grade II by Clavien-Dindo classification.      

'''Conclusion:'''  Our experience showed RaRNU+BCE is an technically feasible and safe procedure for selected patients with upper tract urothelial carcinoma.