Short-term functional outcomes of laparoscopic robotic-assisted cystectomy (RAC) with ileal conduit urinary diversion (ICUD) for lower urinary tract dysfunction (LUTD): A single-center retrospective study

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 346 min (86.5-407.5). The median blood loss was 100 mL (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 61.2 mu mol/L (50.5-74.5) vs 64.5 mu mol/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. Level of evidence: 4 (c) 2024 Elsevier Masson SAS. All rights reserved.