Background: For non-muscle-invasive bladder cancer (NMIBC) requiring radical surgery, limited data are available comparing robotic-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) to open radical cystectomy (ORC). The objective of this study was to compare the two surgical techniques. Methods: A multicentric cohort of 593 patients with NMIBC undergoing iRARC or ORC between 2015 and 2020 was prospectively gathered. Perioperative and pathologic outcomes were compared. Results: A total of 143 patients operated on via iRARC were matched to 143 ORC patients. Operative time was longer in the iRARC group (p= 0.034). Blood loss was higher in the ORC group (p< 0.001), with a consequent increased post-operative transfusion rate in the ORC group (p= 0.003). Length of stay was longer in the ORC group (p= 0.007). Post-operative complications did not differ significantly (allp> 0.05). DFS at 60 months was 55.9% in ORC and 75.2% in iRARC with a statistically significant difference (p= 0.033) found in the univariate analysis. Conclusion: We found that iRARC for patients with NMIBC is safe, associated with a lower blood loss, a lower transfusion rate and a shorter hospital stay compared to ORC. Complication rates were similar. No significant differences in survival analyses emerged across the two techniques.
背景：对于需要根治性手术的非肌层浸润性膀胱癌（NMIBC），目前比较机器人辅助根治性膀胱切除术联合体内尿流改道术（iRARC）与开放性根治性膀胱切除术（ORC）的数据有限。本研究旨在比较这两种手术技术。方法：前瞻性收集了2015年至2020年间接受iRARC或ORC治疗的593例NMIBC患者的多中心队列数据，并对围手术期和病理结果进行比较。结果：共143例接受iRARC手术的患者与143例ORC患者完成匹配。iRARC组手术时间更长（p=0.034），ORC组术中失血量更高（p<0.001），术后输血率也相应增加（p=0.003）。ORC组住院时间更长（p=0.007）。术后并发症发生率无显著差异（所有p>0.05）。单变量分析显示，ORC组60个月无病生存率为55.9%，iRARC组为75.2%，差异具有统计学意义（p=0.033）。结论：本研究发现，对于NMIBC患者，iRARC手术安全可行，与ORC相比具有失血量更少、输血率更低、住院时间更短的优势，且并发症发生率相近。两种技术在生存分析中未显现显著差异。
肿瘤(癌症)患者之家