Presented by: Tunkut Doganca MD
Acibadem Taksim Hospital, Urology

Introduction

The aim of this study is to compare the early period(6^th week after the catheter removal) iatrogenic benign uretero-enteric anastomotic stricture formation between robotic radical cystectomy with extracorporeal urinary diversion, robotic radical cystectomy with intracorporeal urinary diversion(without utilizing ICG) and robotic radical cystectomy with intracorporeal urinary diversion(with utilizing ICG).

Materials

A total of 30 patients(59 renal units) who underwent robotic radical cystectomy with intracorporeal and extracorporeal urinary diversion due to muscle invasive bladder cancer between 2014-2021 in our clinic included in this study.  We retrospectively reviewed the demographic and perioperative results. The primary endpoint of our study was uretero-enteric stricture formation rate at the 6^th week after the single J ureteral catheter removal.

Results

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From our study cohort; 13 of these patients(26 renal units) underwent robotic radical cystectomy with extracorporeal urinary diversion, 10 of these patients(20 renal units) underwent robotic radical cystectomy with intracorporeal urinary diversion(without utilizing ICG) and 7 of these patients(13 renal units) underwent robotic radical cystectomy with intracorporeal urinary diversion(with utilizing ICG). The overall incidence of early period uretero-enteric stricture formation(post-operative 6^th week after the single J catheter removal) was 8.5%(5 renal units); 11,5% (3 renal units) after extracorporeal approach; 10%(2 renal units) after intracorporeal approach(without utilizing ICG). None of the patients with intracorporeal approach (with utilizing ICG) had  demonstrable uretero-enteric stricture at post-operative 6^th week after the single J catheter removal.

Conclusion

In the ICG era; robotic radical cystectomy with intracorporeal diversion is a promising approach in terms of preventing benign uretero-enteric stricture formation when compared with robotic cystectomy with extracorporeal urinary diversion and intracorporeal urinary diversion without utilizing ICG. Larger prospective studies are required to confirm our outcomes.

Funding

None

Co-Authors

Mustafa Bilal Tuna, MD
Acibadem Maslak Hospital, Urology

Omer Burak Argun, MD, Assoc. Prof.
Acibadem University, School of Medicine, Urology

Ilter Tufek, MD, Prof.
Acibadem University, School of Medicine, Urology

Can Obek, MD, Prof.
Acibadem University, School of Medicine, Urology

Ali Riza Kural, MD, Prof.
Acibadem University, School of Medicine, Urology