Purpose To report a multi-institutional experience on robotic radical nephroureterectomy (RNU) and segmental ureterectomy (SU) for upper tract urothelial carcinoma (UTUC). Methods Data were prospectively collected from patients with non-metastatic UTUC undergoing robotic SU or RNU at three referral centers between 2015 and 2018. Transperitoneal, single-docking robotic RNU followed established principles. Bladder cuff excision (BCE) was performed with robotic or open approach. Techniques for SU included: ureteral resection and primary uretero-ureterostomy; partial pyelectomy and modified pyeloplasty; ureteral resection with BCE and direct- or psoas hitch-ureteroneocystostomy. We retrospectively evaluated the technical feasibility, and peri-operative and oncologic outcomes after robotic RNU/SU. Results 81 patients were included. No case required conversion to open surgery. Early major (Clavien–Dindo grade >2) complications were reported in six (7.4%) patients (two after SU, four after RNU). Three patients experienced late major complications (one after SU, two after RNU). Median ΔeGFR at 3 months was − 1 ml/min/1.73 m2 after SU and − 15 ml/ min/1.73 m2 after RNU. Positive surgical margins were recorded in five patients (one after SU, four after RNU). Median follow-up was 21 months and 22 months in the SU and RNU groups, respectively. Three (20%) patients had ipsilateral upper tract recurrence after SU, while five (7.5%) developed metastases after RNU. No case of port-site metastases or peritoneal carcinomatosis was reported. At last follow-up, 67 (82.7%) patients were alive without evidence of disease. Conclusion Robotic SU and RNU are technically feasible and achieved promising peri-operative and oncologic outcomes in selected patients with non-metastatic UTUC.

Robotic radical nephroureterectomy and segmental ureterectomy for upper tract urothelial carcinoma: a multi‐institutional experience / Riccardo Campi, Juliette Cotte, Francesco Sessa, Thomas Seisen, Riccardo Tellini, Daniele Amparore, Nicola Mormile, Aurélien Gobert, Andrea Mari, Francesco Porpiglia, Sergio Serni, Andrea Minervini, Morgan Rouprêt.. - In: WORLD JOURNAL OF UROLOGY. - ISSN 0724-4983. - STAMPA. - (2019), pp. 1-9. [10.1007/s00345-019-02790-y]

Robotic radical nephroureterectomy and segmental ureterectomy for upper tract urothelial carcinoma: a multi‐institutional experience.

Riccardo Campi;Francesco Sessa;Riccardo Tellini;MORMILE, NICOLA;Andrea Mari;Sergio Serni;Andrea Minervini;
2019

Abstract

Purpose To report a multi-institutional experience on robotic radical nephroureterectomy (RNU) and segmental ureterectomy (SU) for upper tract urothelial carcinoma (UTUC). Methods Data were prospectively collected from patients with non-metastatic UTUC undergoing robotic SU or RNU at three referral centers between 2015 and 2018. Transperitoneal, single-docking robotic RNU followed established principles. Bladder cuff excision (BCE) was performed with robotic or open approach. Techniques for SU included: ureteral resection and primary uretero-ureterostomy; partial pyelectomy and modified pyeloplasty; ureteral resection with BCE and direct- or psoas hitch-ureteroneocystostomy. We retrospectively evaluated the technical feasibility, and peri-operative and oncologic outcomes after robotic RNU/SU. Results 81 patients were included. No case required conversion to open surgery. Early major (Clavien–Dindo grade >2) complications were reported in six (7.4%) patients (two after SU, four after RNU). Three patients experienced late major complications (one after SU, two after RNU). Median ΔeGFR at 3 months was − 1 ml/min/1.73 m2 after SU and − 15 ml/ min/1.73 m2 after RNU. Positive surgical margins were recorded in five patients (one after SU, four after RNU). Median follow-up was 21 months and 22 months in the SU and RNU groups, respectively. Three (20%) patients had ipsilateral upper tract recurrence after SU, while five (7.5%) developed metastases after RNU. No case of port-site metastases or peritoneal carcinomatosis was reported. At last follow-up, 67 (82.7%) patients were alive without evidence of disease. Conclusion Robotic SU and RNU are technically feasible and achieved promising peri-operative and oncologic outcomes in selected patients with non-metastatic UTUC.
2019
1
9
Riccardo Campi, Juliette Cotte, Francesco Sessa, Thomas Seisen, Riccardo Tellini, Daniele Amparore, Nicola Mormile, Aurélien Gobert, Andrea Mari, F...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1154822
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