Evaluating the impact of the learning curve on the perioperative outcomes of robot-assisted radical cystectomy with intracorporeal urinary diversion.
Actas Urol Esp (Engl Ed)
; 46(1): 57-62, 2022.
Article
in En, Es
| MEDLINE
| ID: mdl-34840098
ABSTRACT
INTRODUCTION:
Robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is a technically difficult procedure. Our aim was to evaluate the potential impact of the learning curve (LC) on perioperative and pathological outcomes of RARC with ICUD. MATERIAL ANDMETHODS:
Retrospective study of 62 consecutive patients who underwent RARC with ICUD for bladder cancer between 2015-2020. We compared 3 consecutive groups of 20 (G1), 20 (G2), and 22 (G3) patients to analyze the impact of the LC. G1 cases were performed by a senior surgeon experienced in robotic surgery, while G2-G3 were performed by 2 junior surgeons without experience under the mentorship of the senior surgeon.RESULTS:
The 3 groups had similar clinical and pathological characteristics. A total of 15 patients (24%) received a neobladder and 47 (75%) an ileal conduit. The mean operative time decreased 60â¯min between G1-G3 (pâ¯=â¯0.001). No conversions to open approach or intraoperative complications were reported. There were no differences between groups regarding positive margin rates (pâ¯=â¯0.6) or the number of lymph nodes removed (pâ¯=â¯0.061). The postoperative complication rate was 77% and did not change during the LC (pâ¯=â¯0.49). Uretero-enteric stricture rate decreased from 25% in G1 to 9% in G3 (pâ¯=â¯0.217).CONCLUSIONS:
The inclusion of junior surgeons to a RARC with ICUD program after the initial 20 cases does not have an impact on the perioperative and pathological outcomes of the procedure. The operative time and the uretero-enteric stricture rate could be reduced during the LC.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Urinary Diversion
/
Robotics
Type of study:
Observational_studies
Limits:
Humans
Language:
En
/
Es
Journal:
Actas Urol Esp (Engl Ed)
Year:
2022
Document type:
Article
Affiliation country:
España