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Purpose <p>To compare the perioperative, functional, and oncological outcomes of the intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) technique following robot-assisted radical cystectomy (RARC).</p> Methods <p>We reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from July 2016 to February 2023. Patients were divided into 2 groups according to the approach of reconstruction (ICNB or ECNB). The chi-squared test and Wilcoxon test were used to summarize categorical and continuous variables, respectively. survival and complication outcomes were analyzed using Kaplan-Meier curves, multivariate logistic regression and Cox hazards models.</p> Result <p>Among 304 patients, 190 ICNB patients and 114 ECNB patients were identified. A shorter median operative time (320 vs. 354&#xa0;min; <i>p</i> = 0.001) and less median EBL (300 vs. 500&#xa0;ml; <i>p</i> &lt; 0.001) were recorded in the ICNB group. A significant difference in 90-d overall complications was detected between the 2 groups (49.5% vs. 61.4%; <i>p</i> = 0.043). Multivariate logistic regression analysis demonstrated that age, relapsed tumor and surgical approach (ECNB/ICNB) were individual predictive factors for 90-d overall complications. The functional outcomes and survival rates were comparable between the ICNB and ECNB groups. A Cox proportional hazards model indicated that higher pathological stage and pN status are predictors of both recurrence-free survival (RFS) and overall survival (OS).</p> Conclusion <p>Compared with ECNB, ICNB significantly improves perioperative outcomes without compromising functional or oncological outcomes.</p>

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Intracorporeal versus extracorporeal neobladder in robot-assisted radical cystectomy: perioperative, oncological, and functional outcomes from a single-institutional experience

  • 期刊论文

  • 发表日期：

    2025年3月11日

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  • Bing Yan,
  • Yuan Liu,
  • Yang Liu,
  • Ji Zheng,
  • Peng He,
  • Xuemei Li,
  • Yuwei Li,
  • Yuting Liu,
  • Xiaozhou Zhou,
  • Zhiwen Chen

摘要

Purpose

To compare the perioperative, functional, and oncological outcomes of the intracorporeal neobladder (ICNB) and extracorporeal neobladder (ECNB) technique following robot-assisted radical cystectomy (RARC).

Methods

We reviewed our single-institutional, prospectively collected database for consecutive patients who underwent RARC with an ileum neobladder from July 2016 to February 2023. Patients were divided into 2 groups according to the approach of reconstruction (ICNB or ECNB). The chi-squared test and Wilcoxon test were used to summarize categorical and continuous variables, respectively. survival and complication outcomes were analyzed using Kaplan-Meier curves, multivariate logistic regression and Cox hazards models.

Result

Among 304 patients, 190 ICNB patients and 114 ECNB patients were identified. A shorter median operative time (320 vs. 354 min; p = 0.001) and less median EBL (300 vs. 500 ml; p < 0.001) were recorded in the ICNB group. A significant difference in 90-d overall complications was detected between the 2 groups (49.5% vs. 61.4%; p = 0.043). Multivariate logistic regression analysis demonstrated that age, relapsed tumor and surgical approach (ECNB/ICNB) were individual predictive factors for 90-d overall complications. The functional outcomes and survival rates were comparable between the ICNB and ECNB groups. A Cox proportional hazards model indicated that higher pathological stage and pN status are predictors of both recurrence-free survival (RFS) and overall survival (OS).

Conclusion

Compared with ECNB, ICNB significantly improves perioperative outcomes without compromising functional or oncological outcomes.