eprintid: 1560871
rev_number: 40
eprint_status: archive
userid: 608
dir: disk0/01/56/08/71
datestamp: 2017-06-30 12:34:29
lastmod: 2021-12-17 22:59:25
status_changed: 2017-11-02 12:10:21
type: article
metadata_visibility: show
creators_name: Khetrapal, P
creators_name: Tan, WS
creators_name: Lamb, B
creators_name: Tan, M
creators_name: Baker, H
creators_name: Thompson, J
creators_name: Sridhar, A
creators_name: Kelly, JD
creators_name: Briggs, T
title: The Role of Robotics in the Invasive Management of Bladder Cancer
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D16
divisions: G88
keywords: Science & Technology, Life Sciences & Biomedicine, Urology & Nephrology, Robotic cystectomy, Intracorporeal, Extracorporeal, Bladder cancer, Enhanced recovery, ASSISTED RADICAL CYSTECTOMY, EXTRACORPOREAL URINARY-DIVERSION, ENHANCED RECOVERY PROGRAM, LEARNING-CURVE, LAPAROSCOPIC CYSTECTOMY, CUMULATIVE ANALYSIS, INITIAL-EXPERIENCE, COLORECTAL SURGERY, OUTCOMES, COMPLICATIONS
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique. For intracorporeal RARC (iRARC), this urinary reconstruction is performed robotically without further incisions. There are theoretical benefits to this approach such as reduced recovery time for the bowel and reduced ileus rates, but no level 1 evidence currently exists to support this. While there has been an improvement in patient outcomes since the adoption of RARC, various other factors, such as enhanced recovery programmes and surgical learning curve, have made it difficult to attribute this solely to the robotic approach as many centres performing ORC have also shown similar improvements. In this review, we will discuss implementation of RARC as well as perioperative measures that have helped improve outcomes, offer a comparison of outcomes between ORC and RARC and highlight upcoming RCTs that may offer new evidence for or against a paradigm shift in the future of bladder cancer surgery.
date: 2017-06-20
date_type: published
publisher: SPRINGER
official_url: https://doi.org/10.1007/s11934-017-0706-7
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1299545
doi: 10.1007/s11934-017-0706-7
lyricists_name: Kelly, John
lyricists_name: Khetrapal, Pramit
lyricists_name: Sridhar, Ashwin
lyricists_name: Tan, Wei Shen
lyricists_id: JDKEL61
lyricists_id: PKHET40
lyricists_id: ASRID01
lyricists_id: WSTAN49
full_text_status: public
publication: Current Urology Reports
volume: 18
article_number: 57
pages: 7
issn: 1527-2737
citation:        Khetrapal, P;    Tan, WS;    Lamb, B;    Tan, M;    Baker, H;    Thompson, J;    Sridhar, A;         ... Briggs, T; + view all <#>        Khetrapal, P;  Tan, WS;  Lamb, B;  Tan, M;  Baker, H;  Thompson, J;  Sridhar, A;  Kelly, JD;  Briggs, T;   - view fewer <#>    (2017)    The Role of Robotics in the Invasive Management of Bladder Cancer.                   Current Urology Reports , 18     , Article 57.  10.1007/s11934-017-0706-7 <https://doi.org/10.1007/s11934-017-0706-7>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1560871/1/Kelly_%20management%20of%20bladder%20cancer.pdf