Pd02-03 Ureteroenteric Strictures of Open vs Robot-Assisted Radical Cystectomy With Totally Intracorporeal Urinary Diversion: Single Centre Prospective Randomised Controlled Trial

You have accessJournal of UrologyBladder Cancer: Invasive I (PD02)1 May 2024PD02-03 URETEROENTERIC STRICTURES OF OPEN VS ROBOT-ASSISTED RADICAL CYSTECTOMY WITH TOTALLY INTRACORPOREAL URINARY DIVERSION: SINGLE CENTRE PROSPECTIVE RANDOMISED CONTROLLED TRIAL Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Simone D'Annunzio, Mariaconsiglia C. Ferriero, Leonardo Misuraca, Salvatore Guaglianone, Michele Gallucci, 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 , Leonardo MisuracaLeonardo Misuraca , Salvatore GuaglianoneSalvatore Guaglianone , Michele GallucciMichele Gallucci , and Giuseppe SimoneGiuseppe Simone View All Author Informationhttps://doi.org/10.1097/01.JU.0001008836.73392.92.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Higher incidence of ureteroenteric strictures (UES) in patients receiving RARC with extracorporeal urinary diversion (UD) compared with ORC have been reported. Poor data are available for RARC with intacroporeal iUD. In this RCT comparing ORC and RARC with iUD (NCT03434132), we evaluated the risk of developing UES in both arms. METHODS: Eligibility criteria: TURBt with cT2-4, cN0, cM0, or recurrent HG NMIBC and no anesthesiologic contraindications to robotic surgery. Between Jan 2018 and Sept 2020, patients were enrolled with a covariate adaptive randomization process based on: BMI, ASA score, preoperative Hgb, UD, neoadiuvant chemo and cT-stage. Aim of this study was to evaluate UES rates comparison between ORC and RARC with totally iUD. Patients were followed-up quarterly until 2yrs after surgery. UES was defined as any hydronephrosis grade highlighted at CT-scan images during follow-up. Continuous and categorical variables were compared using Student t and Chi-Square tests, respectively. Kaplan-Meier (KM) method and the log-rank test were applied to compare UES along time. Cox regression analysis was used to assess the role of surgical approach as predictor of UES development risk. RESULTS: Overall, 116 patients were enrolled. Both groups were homogeneous for all clinical features (all p>0.15 (Table 1). In the robotic group, UD was performed in all cases with a totally intracorporeal approach. Perioperative outcomes were reported (Table 2). No differences occurred postoperatively (all p>0.20). At a median follow-up of 22 mo (IQR 15-31), overall UES rates were comparable (RARC:28%vsORC:16%; p=0.17). 1-yr KM analysis displayed comparable UES probabilities for each side (Figure 1). At univariable Cox regression analysis RARC was not a significant predictor of UES risk (HR 2.05, 95% CI 0.9-4.7, p=0.08). CONCLUSIONS: This RCT confirm comparable UES rates between ORC and RARC with totally iUD, mostly whithin the first yr. The higher incidence of UES rates in both arms compared with Literature and with historical internal series is likely to be due to a strict follow-up protocol and to the very low (1%) incidence of patients lost to follow-up. The non significant differences UES development risks between RARC and ORC can be due to underpowered analysis. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e69 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 Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...