Efficacy and safety of robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction
10.3969/j.issn.1009-8291.2025.02.009
- VernacularTitle:机器人辅助改良Y型原位新膀胱术的疗效和安全性
- Author:
Tonglei ZHAO
1
,
2
;
Weipu MAO
3
;
Yiduo WANG
3
;
Bin XU
3
,
4
;
Shuqiu CHEN
3
;
Weidong ZHU
3
;
Ming CHEN
3
,
4
,
5
;
Jianping WU
3
,
5
Author Information
1. Southeast University School of Medicine, Nanjing 210003
2. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009
3. Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009
4. Surgical Research Center, Institute of Urology, Southeast University Medical School, Nanjing 210018
5. Department of Urology, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211299, China
- Publication Type:Journal Article
- Keywords:
bladder cancer;
robot-assisted laparoscopy;
radical cystectomy;
modified Y-shaped ileal orthotopic neobladder;
urinary diversion
- From:
Journal of Modern Urology
2025;30(2):137-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the efficacy and safety of robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction，so as to provide reference for clinical practice. Methods: The clinical data of 44 patients who underwent robot-assisted laparoscopic radical cystectomy，lymph node dissection，and modified Y-shaped ileal orthotopic neobladder reconstruction during Feb.2020 and Aug.2022 were retrospectively analyzed.The surgical position，Trocar position，and key surgical steps were reported.The perioperative conditions，postoperative complications，neobladder volume，maximum urinary flow rate，postvoid residual，renal function，and urinary control function were recorded. Results: All 44 surgeries were successfully completed，with operation time of (314.32±51.02) min，modified Y-shaped ileal orthotopic neobladder reconstruction time of (103.52±9.56) min，and bleeding volume of (128.18±57.27) mL.The postoperative time for fluid intake was (4.16±0.86) days，catheter indwelling time was (14.02±3.20) days，and patients were discharged 1 to 2 days after catheter removal.Clavien-Dindo grade Ⅱ and Ⅲ complications occurred in 15 and 2 patients，respectively.During the follow-up of (20.77±5.90) months，dysuria occurred in 1 case，urethral calculi in 2 cases，and incomplete bowel obstruction in 2 cases. The postoperative neobladder capacity was (195.75±15.51) mL，maximal urinary flow rate (20.30±2.05) mL/s，postvoid residual (19.86±13.80) mL and serum creatinine (81.98±25.97) μmol/L. The incidence of daytime and nocturnal urinary incontinence 3，6 and 12 months after operation were 20.45% and 29.55%，11.36% and 18.18%，and 4.55% and 9.09%，respectively. Conclusion: Robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction has favorable efficacy and safety，and low incidence of postoperative complications，which can be applied in clinical practice.
