Robotic surgery in organ-preserving treatment of muscle-invasive form of bladder cancer

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DOI: 10.29188/2222-8543-2020-12-2-92-97

Arevin A.G., Grickevich A.A., Miroshkina I.V., Karel'skaya N.A., Teplov A.A.
№2 2020

Introduction. Organ-preserving treatment of bladder cancer (BC) is an acute problem in modern oncourology. Presently, the gold standard of treatment for muscle-invasive BC is radical cystectomy. However, the search for new organ-preserving methods remains to be relevant.

Aim. To review available publications dedicated to organ-preserving robot-assisted surgical treatment of muscle-invasive BC.

Materials and methods. The literature search was conducted using the Pubmed database by the following keywords: robotic bladder resection and robot-assisted bladder resection. The feasibility of robot-assisted bladder resection in patients with muscle-invasive BC was assessed following the analysis of 36 Russian and foreign publications.

Results. Bladder resection is an alternative method of treatment for selected patients, which requires subsequent life-long monitoring. Robotassisted bladder resection was first mentioned in 2008. The application of the Da Vinci robotic surgical complex for bladder resection has a number of advantages: moderate hemorrhage and a short period of hospitalization (1–5 days). However, this method requires additional research due to the lack of large-scale studies. Available studies involved a limited number of patients. Moreover, no studies have thus far been performed to compare open and robot-assisted bladder resection.

Conclusions. In order to achieve favourable oncologic results in patients after bladder resection, which could be compared to those after cystectomy, a thorough selection of candidates for such operations should be performed. Due to better visualization, robot-assisted bladder resection allows tumour resection to be conducted with maximum precision. The application of the Da Vinci robotic surgical complex for bladder resection in certain patient groups decreases the period of hospitalization and rehabilitation, as well as reduces the rate of complications. The comparison of robot-assisted bladder resection with other cystectomy methods is a promising research direction.

Conflict of interest. The authors declare no conflict of interest.

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