PD34-05 STAPLED VERSUS TOTALLY HAND-SEWN ROBOTIC INTRACORPOREAL ORTHOTOPIC NEOBLADDER: PERIOPERATIVE, POSTOPERATIVE AND FUNCTIONAL OUTCOMES

You have accessJournal of UrologyBladder Cancer: Invasive III (PD34)1 May 2024PD34-05 STAPLED VERSUS TOTALLY HAND-SEWN ROBOTIC INTRACORPOREAL ORTHOTOPIC NEOBLADDER: PERIOPERATIVE, POSTOPERATIVE AND FUNCTIONAL OUTCOMES Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Simone D'Annunzio, Mariaconsiglia C. Ferriero, Rocco Simone Flammia, Leonardo Misuraca, Flavia Proietti, Marianna Anselmi, Salvatore Guaglianone, Costantino Leonardo, and Giuseppe Simone Riccardo MastroianniRiccardo Mastroianni , Gabriele TudertiGabriele Tuderti , Umberto AnceschiUmberto Anceschi , Alfredo Maria BoveAlfredo Maria Bove , Aldo BrassettiAldo Brassetti , Simone D'AnnunzioSimone D'Annunzio , Mariaconsiglia C. FerrieroMariaconsiglia C. Ferriero , Rocco Simone FlammiaRocco Simone Flammia , Leonardo MisuracaLeonardo Misuraca , Flavia ProiettiFlavia Proietti , Marianna AnselmiMarianna Anselmi , Salvatore GuaglianoneSalvatore Guaglianone , Costantino LeonardoCostantino Leonardo , and Giuseppe SimoneGiuseppe Simone View All Author Informationhttps://doi.org/10.1097/01.JU.0001008768.36634.79.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of staplers during robot-assisted radical cystectomy (RARC) with totally intracorporeal orthotopic neobladder (i-ON) has been introduced to simplify an otherwise complex procedure. The study aimed to compare peri-, postoperative and functional outcomes between stapled (ST) and hand sewn (HS) RARC with iON. METHODS: Baseline demographic, clinical, peri- and postoperative outcomes of all consecutive patients treated between Jan 2018 and Jul 2023 were collected. In ST-iON cohort one 60-mm or 2 sequential 45-mm stapler loads were applied to detubularize and create the neobladder neck and the first folding. In Jun 2021 we introduced HS-iON using 2-0 barbed running sutures. Continuous and categorical variables were compared using Kruskal Wallis and Chi-Square tests. Kaplan-Meier (KM) method and the log-rank test were applied to assess functional outcomes. Cox-regression analysis was performed to adjust for possible confounders and to identify predictors of day- and night-time continence recovery. RESULTS: Overall, 116 patients were enrolled (Table 1). No differences occurred in terms of perioperative outcomes, except for hospital stay, being shorter in the HS-iON cohort (p<0.001). Similarly, no differences were reported in terms of 30d (p=0.17) and 90d (p=0.69) complications rate. Stone rate was significantly lower in HS-iON cohort (p=0.01) (Table 2). At KM analysis, HS-iON patients displayed significantly higher day- (1yr: HS iON 89% ± 4.8 vs ST-iON 58% ± 7.1, p<0.001) and night-time continence recovery probabilities (1yr: HS iON 58% ± 7.9 vs ST-iON 35% ± 6.7, p<0.001) (Figure 1, 2). At Cox-regression analysis, the only independent predictor of day- and night-time continence recovery was sex-sparing approach. Excluding patients underwent sex-sparing RC, no predictors of day-time continence recovery were detected, while HS was the only predictor of night-time continence recovery [HR: 2.6 (95%CI 1.27-5.34), p=0.009]. CONCLUSIONS: HS proved to be the reference standard to configure iON during RARC. ST-iON did not prove to either reduce operative times or perioperative complications, while significantly impacting on risk of stone formations and night-time continence recovery. Whenever oncologically feasible, sex-sparing approach should be preferred to improve functional outcomes. Download PPTDownload PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e719 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Simone D'Annunzio More articles by this author Mariaconsiglia C. Ferriero More articles by this author Rocco Simone Flammia More articles by this author Leonardo Misuraca More articles by this author Flavia Proietti More articles by this author Marianna Anselmi More articles by this author Salvatore Guaglianone More articles by this author Costantino Leonardo More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...