The success of robot-assisted cystectomy in the treatment of muscle-invasive bladder cancer

摘要

Background. Bladder cancer is a serious problem of modern oncourology due to the annual increase in the number of diagnosed malignant neoplasms of the urinary system. High-risk muscle-invasive and non-muscle-invasive forms are subject to surgical treatment, while open radical cystectomy serves as the “gold standard”. Laparoscopic and robot-assisted radical cystectomy are serious competitors to this method. To date, the robotic method of removing the bladder is the least studied, despite the fact that it seems to be the most technologically advanced and modern.Aim. To analyze the own results of the use of robot-assisted interventions in high-risk musculoskeletal and non-musculoskeletal invasive bladder cancer, as well as to study the literature on the use of robot-assisted radical cystectomy in the treatment of malignant neoplasms of the bladder.Materials and methods. A prospective study was conducted on the basis of the clinic of the Bashkir State Medical University with the participation of 70 patients who were diagnosed with bladder cancer (T1–T4). The subjects underwent a robot-assisted radical cystectomy with various variants of urine derivation.Results. At the end of the study, the outcomes after robot-assisted radical cystectomy were analyzed and evaluated. The primary endpoints were 30- and 90-day complications of the Clavien–Dindo system. According to secondary indicators, robot-assisted radical cystectomy demonstrated a low duration of surgery, intraoperative blood loss.Conclusion. Robot-assisted radical cystectomy is a serious competitor to open and laparoscopic interventions for early and long-term perioperative indicators. This technique has shown its profitability in the treatment of bladder cancer, demonstrating a sufficient level of effectiveness and safety.