Journal ArticleDOI
Single-stage Xi® robotic radical nephroureterectomy for upper tract urothelial carcinoma: surgical technique and outcomes
TLDR
In this paper , the authors describe the surgical steps and the outcomes of a single-stage robotic urothelial carcinoma (RNU) without patients repositioning and robot re-docking.Abstract:
Radical nephroureterectomy (RNU) represents the standard of care for high grade upper tract urothelial carcinoma (UTUC). Open and laparoscopic approaches are well-established treatments, but evidence regarding robotic RNU is growing. The introduction of the Xi® system facilitates the implementation of this multi-quadrant procedure. The aim of this video-article is to describe the surgical steps and the outcomes of Xi® robotic RNU.Single stage Xi® robotic RNU without patients repositioning and robot re-docking were done between 2015 and 2019 and collected in a large worldwide multi-institutional study, the ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST). Institutional review board approval and data share agreement were obtained at each center. Surgical technique is described in detail in the accompanying video. Descriptive statistics of baseline characteristics and surgical, pathological, and oncological outcomes were analyzed.Overall, 148 patients were included in the analysis; 14% had an ECOG >1 and 68.2% ASA ≥3. Median tumor dimension was 3.0 (IQR:2.0-4.2) cm and 34.5% showed hydronephrosis at diagnosis. Forty-eight% were cT1 tumors. Bladder cuff excision and lymph node dissection were performed in 96% and 38.1% of the procedures, respectively. Median operative time and estimated blood loss were 215.5 (IQR:160.5-290.0) minutes and 100.0 (IQR: 50.0-150.0) mL, respectively. Approximately 56% of patients took opioids during hospital stay for a total morphine equivalent dose of 22.9 (IQR:16.0-60.0) milligrams equivalent. Post-operative complications were 26 (17.7%), with 4 major (2.7%). Seven patients underwent adjuvant chemotherapy, with median number of cycles of 4.0 (IQR:3.0-6.0).Single stage Xi® RNU is a reproducible and safe minimally invasive procedure for treatment of UTUC. Additional potential advantages of the robot might be a wider implementation of LND with a minimally invasive approach. read more
Citations
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Journal ArticleDOI
Robotic vs laparoscopic nephroureterectomy for upper tract urothelial carcinoma: a multicenter propensity-score matched pair "tetrafecta" analysis (ROBUUST collaborative group).
Alessandro Veccia,Umberto Carbonara,Hooman Djaladat,Reza Mehrazin,Daniel Eun,Adam C. Reese,Xiaosong Meng,Robert G. Uzzo,Abhishek K. Srivastava,James Porter,Jason Farrow,Marcus Jamil,Giuseppe Rosiello,Riccardo Tellini,Andrea Mauri,A. Al-Qathani,Koon Ho Rha,Lin-hui Wang,Riccardo Mastroianni,Matteo Ferro,Ottavio De Cobelli,Kevin N. Hakimi,Fabio Crocerossa,Alireza Ghoreifi,Giovanni Cacciamani,Amit Amit S Bhattu,Alexandre Mottrie,Firas Abdollah,Andrea Minervini,Zhenjie Wu,P. De Simone,Ithaar Derweesh,Mark L. Gonzalgo,Vitaly Margulis,Chandru P. Sundaram,Riccardo Autorino +35 more
TL;DR: The implementation of robotics might facilitate achievement of a "tetrafecta" outcome as defined in the present study, and RRNU seems to offer shorter hospital stay but this might be related to the different geographical location of participating centers.
Journal ArticleDOI
Ureteroscopy and tailored treatment of upper tract urothelial cancer: recent advances and unmet needs
Davide Loizzo,Savio Domenico Pandolfo,Francesco Del Giudice,Clara Cerrato,Benjamin I. Chung,Zhenjie Wu,Ciro Imbimbo,Pasquale Ditonno,Ithaar Derweesh,Riccardo Autorino +9 more
TL;DR: This work presents a meta-analyses of the Urology and Kidney Transplantation Units at the National Institutes of Health (NIH) in the United States and China that shows clear trends in prognosis and in particular in the management of high-risk patients with highurden urology conditions.
Journal ArticleDOI
Robot-assisted vs. laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma: a systematic review and meta-analysis based on comparative studies
Ruoyu Ji,Zhangyuting He,Shi Ming Fang,Wenjie Yang,Mengchao Wei,Jie Dong,Weifeng Xu,Zhigang Ji +7 more
TL;DR: For UTUC patients, RANU offers fewer complications and shorter hospitalization, however, R ANU requires longer operative time and shares similar oncologic outcomes compared to LNU.
Journal ArticleDOI
ASO Author Reflections: Comparison of Perioperative Outcomes and Complications of Laparoscopic and Robotic Nephroureterectomy Approaches in Patients with Upper-Tract Urothelial Carcinoma
Lei da Peng,Irfan Mehmud,Chunyang Meng,Dongdong Tang,Kangsen Li,Lijian Gan,Jinze Li,Fu Yi,Yunxiang Li +8 more
Journal ArticleDOI
Necessity of prophylactic drainage tube in retroperitoneal laparoscopic nephroureterectomy with open distal ureterectomy: A matched-pair analysis.
Hiroki Hagimoto,T. Kambe,Yutaka Mine,Hidetoshi Kokubun,Yuto Hattori,Yohei Abe,Masashi Kubota,Naofumi Tsutsumi,Toshinari Yamasaki,Mutsushi Kawakita +9 more
TL;DR: In this article , the authors compared the postoperative outcomes between the patients with drain placement (D+ group) and without drain placement using propensity score matching, and found that omitting the drainage tube after laparoscopic radical nephroureterectomy did not increase postoperative complications or lymphocele and shortened the post-hospital stay.
References
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Journal ArticleDOI
Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial.
Alison Birtle,Alison Birtle,Mark Johnson,John D. Chester,Robert Jones,David Dolling,Richard T. Bryan,Chris Harris,Andrew Winterbottom,Anthony Blacker,James W.F. Catto,Prabir Chakraborti,Jenny L Donovan,Paul Anthony Elliott,Ann French,Satinder Jagdev,Benjamin Jenkins,Francis X. Keeley,Roger Kockelbergh,Thomas Powles,John Wagstaff,Caroline Wilson,Rachel Todd,Rebecca Lewis,Emma Hall +24 more
TL;DR: Gemcitabine–platinum combination chemotherapy initiated within 90 days after nephroureterectomy significantly improved disease-free survival in patients with locally advanced UTUC in a phase 3, open-label, randomised controlled trial.
Journal ArticleDOI
Neoadjuvant and Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma: A 2020 Systematic Review and Meta-analysis, and Future Perspectives on Systemic Therapy.
Jeffrey J. Leow,Jeffrey J. Leow,Jeffrey J. Leow,Yew Lam Chong,Yew Lam Chong,Steven L. Chang,Begoña P. Valderrama,Thomas Powles,Joaquim Bellmunt +8 more
TL;DR: The pooled evidence shows that perioperative chemotherapy was beneficial for prolonging survival; however, the evidence for adjuvant chemotherapy was stronger than that for neoadjuvant chemotherapy.
Journal ArticleDOI
Robotic-assisted nephroureterectomy and bladder cuff excision without intraoperative repositioning.
TL;DR: RNUBCE, with lymphadenectomy when clinically indicated, provides a viable treatment option for patients with upper tract transitional cell carcinoma and is described as a novel technique for successful performance of robotic nephroureterectomy with bladder cuff excision.
Journal ArticleDOI
Laparoscopic Radical Nephroureterectomy for Upper Tract Transitional Cell Carcinoma: Oncological Outcomes at 7 Years
Andre Berger,Georges-Pascal Haber,Kazumi Kamoi,Monish Aron,Mihir M. Desai,Jihad H. Kaouk,Inderbir S. Gill +6 more
TL;DR: To the authors' knowledge the largest long-term followup after laparoscopic nephroureterectomy for upper tract transitional cell carcinoma is presented andLong-term oncological outcomes appear comparable to those of open surgery.
Journal ArticleDOI
Initial experience of robotic nephroureterectomy: a hybrid-port technique.
TL;DR: To report a new technique of robot‐assisted laparoscopic nephroureterectomy (RANU) using a hybrid port, as RANU has recently become a minimally invasive treatment option for upper tract transitional cell carcinoma (TCC).
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