Robot-assisted laparoscopic cystectomy with non-continent urinary diversion for neurogenic lower urinary tract dysfunction: Midterm outcomes.
cystectomy
ileal conduit
neurogenic bladder
robotic surgical procedures
urinary diversion
Journal
Neurourology and urodynamics
ISSN: 1520-6777
Titre abrégé: Neurourol Urodyn
Pays: United States
ID NLM: 8303326
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
revised:
21
12
2022
received:
22
08
2022
accepted:
16
01
2023
pubmed:
26
1
2023
medline:
17
3
2023
entrez:
25
1
2023
Statut:
ppublish
Résumé
The aim of this study was to assess midterm functional outcomes and complications of robot-assisted laparoscopic cystectomy with non-continent urinary diversion in patients with neurogenic lower urinary tract dysfunction. We performed a retrospective single center study including all patients who underwent robot-assisted laparoscopic cystectomy with non-continent urinary diversion between January 2008 and December 2018 for neurogenic lower urinary tract dysfunction. Perioperative data, early and late complications, reoperation rate, renal function, and patient satisfaction (PGI-I) were evaluated. One hundred and forty patients were included (70 multiple sclerosis, 37 spinal cord injuries, 33 others) with a median follow-up of 29 months (12-49). The main indication for surgery was an inability to perform intermittent self-catheterization (n = 125, 89%). The early complication rate (<30 days) was 41% (n = 58), including 72% (n = 45) minor complications (Clavien I-II) and 29% (n = 17) major complications (Clavien III-V). Three patients died in the early postoperative period. Late complications appear in 41% (n = 57), with 9% (n = 13) being ureteroileal anastomotic stricture. The overall reintervention rate was 19% (n = 27), mainly for lithiasis surgery. Pre- and postoperative renal function were comparable. Most of patients reported an improvement in their quality of life following their surgery (PGI-I 1-2). Robot-assisted laparoscopic cystectomy with non-continent urinary diversion may be of particular interest in patients with neurogenic lower urinary tract dysfunction who are unable to benefit from conservative treatment, as it provides midterm protection of the upper urinary tract and an improvement in quality of life.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
586-596Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Gajewski JB, Schurch B, Hamid R, et al. An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD. Neurourol Urodyn. 2018;37(3):1152-1161. doi:10.1002/nau.23397
Çetinel B, Önal B, Can G, Talat Z, Erhan B, Gündüz B. Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a retrospective study. Neurourol Urodyn. 2017;36(3):653-658. doi:10.1002/nau.22984
Groen J, Pannek J, Castro Diaz D, et al. Summary of European association of urology (EAU) guidelines on neuro-urology. Eur Urol. 2016;69(2):324-333. doi:10.1016/j.eururo.2015.07.071
Denys P, Chartier-Kastler E, Even A, Joussain C. How to treat neurogenic bladder and sexual dysfunction after spinal cord lesion. Rev Neurol. 2021;177(5):589-593. doi:10.1016/j.neurol.2020.07.013
Wyndaele JJ, Birch B, Borau A, et al. Surgical management of the neurogenic bladder after spinal cord injury. World J Urol. 2018;36(10):1569-1576. doi:10.1007/s00345-018-2294-7
Abrams P, Andersson KE, Apostolidis A, et al. 6th international consultation on incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn. 2018;37(7):2271-2272.
Chkir S, Michel F, Akakpo W, et al. Non-continent urinary diversion (Ileal Conduit) as salvage therapy in patients with refractory lower urinary tract dysfunctions due to multiple sclerosis: results of a national cohort from the French Association of Urology (AFU) Neurourology Committee and the French-speaking Neurourology Study Group (GENULF). Urology. 2022;168(22):216-221. doi:10.1016/j.urology.2022.06.014
Weld KJ, Dmochowski RR. Effect of bladder management on urological complications in spinal cord injured patients. J Urol. 2000;163(3):768-772.
Parra RO, Andrus CH, Jones JP, Boullier JA. Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol. 1992;148(4):1140-1144. doi:10.1016/s0022-5347(17)36843-x
Guillotreau J, Castel-Lacanal E, Roumiguié M, et al. Prospective study of the impact on quality of life of cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction. Neurourol Urodyn. 2011;30(8):1503-1506. doi:10.1002/nau.21121
Guillotreau J, Panicker JN, Castel-Lacanal E, et al. Prospective evaluation of laparoscopic assisted cystectomy and ileal conduit in advanced multiple sclerosis. Urology. 2012;80(4):852-857. doi:10.1016/j.urology.2012.06.039
Novara G, Catto JWF, Wilson T, et al. Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy. Eur Urol. 2015;67(3):376-401. doi:10.1016/j.eururo.2014.12.007
de Sèze M, Ruffion A, Denys P, Joseph PA, Perrouin-Verbe B, GENULF. The neurogenic bladder in multiple sclerosis: review of the literature and proposal of management guidelines. Multiple Sclerosis J. 2007;13(7):915-928. doi:10.1177/1352458506075651
Deboudt C, Perrouin-Verbe MA, Le Normand L, Perrouin-Verbe B, Buge F, Rigaud J. Comparison of the morbidity and mortality of cystectomy and ileal conduit urinary diversion for neurogenic lower urinary tract dysfunction according to the approach: laparotomy, laparoscopy or robotic. Int J Urol. 2016;23(10):848-853. doi:10.1111/iju.13166
Chartier-Kastler E, Mozer P, Denys P, Bitker MO, Haertig A, Richard F. Neurogenic bladder management and cutaneous non-continent ileal conduit. Spinal Cord. 2002;40(9):443-448. doi:10.1038/sj.sc.3101346
Wallace DM. Ureteric diversion using a conduit: a simplified technique. Br J Urol. 1966;38(5):522-527.
Dindo D, Demartines N, Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213.
Costa P, Costa P, Perrouin-Verbe B, et al. Quality of life in spinal cord injury patients with urinary difficulties. Eur Urol. 2001;39(1):107-113. doi:10.1159/000052421
Bonniaud V, Bryant D, Parratte B, Guyatt G. Qualiveen, a urinary-disorder specific instrument: 0.5 corresponds to the minimal important difference. JCE. 2008;61(5):505-510. doi:10.1016/j.jclinepi.2007.06.008
Guillot-Tantay C, Chartier-Kastler E, Perrouin-Verbe MA, Denys P, Léon P, Phé V. Complications of non-continent cutaneous urinary diversion in adults with spinal cord injury: a retrospective study. Spinal Cord. 2018;56(9):856-862. doi:10.1038/s41393-018-0083-1
Akakpo W, Chartier-Kastler E, Joussain C, Denys P, Lubetzki C, Phé V. Outcomes of ileal conduit urinary diversion in patients with multiple sclerosis. Neurourol Urodyn. 2020;39(2):771-777. doi:10.1002/nau.24279
Mazouin C, Hubert J, Tricard T, et al. Robot-assisted cystectomy and ileal conduit for neurogenic bladder: comparison of extracorporeal vs intracorporeal urinary diversion. J Endourol. 2021;35(9):1350-1356. doi:10.1089/end.2020.0921
Doizi S, Traxer O. Kidney stone in a patient with an Ileal Conduit. Eur Urol Focus. 2017;3(1):14-15.
Haudebert C, Hascoet J, Freton L, et al. Cystectomy and ileal conduit for neurogenic bladder: comparison of the open, laparoscopic and robotic approaches. Neurourol Urodyn. 2022;41(2):601-608. doi:10.1002/nau.24855
Legrand G, Rouprêt M, Comperat E, Even-Schneider A, Denys P, Chartier-Kastler E. Functional outcomes after management of end-stage neurological bladder dysfunction with ileal conduit in a multiple sclerosis population: a monocentric experience. Urology. 2011;78(4):937-941. doi:10.1016/j.urology.2011.06.015