Review of intracorporeal and extracorporeal continent urinary diversion - where do we stand in 2021?

Abstract

Robot-assisted radical cystectomy has become widely accepted as a safe and minimally invasive procedure for the treatment of bladder cancer. The urinary diversion continues to be performed completely intracorporeally or extracorporeally. Over the past decade, there has been an increasing number of continent diversions being performed intracorporeally. We evaluated the most recent literature regarding intraoperative metrics and outcomes that compare the intracorporeal and extracorporeal approaches.

Keywords

Cystectomy / intracorporeal / extracorporeal / continent urinary diversion

References

[1] Menon M,Tewari A.Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion.BJU Int2003;92:232-6

[2] Gandaglia G,Geurts N.Oncologic outcomes of robot-assisted radical cystectomy: results of a high-volume robotic center.J Endourol2016;30:75-82

[3] Parekh DJ,Castle EP.Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial.Lancet2018;391:2525-36

[4] Beecken W,Engl T.Robotic-assisted laparoscopic radical cystectomy and intra-abdominal formation of an orthotopic ileal neobladder.Eur Urol2003;44:337-9

[5] Hussein AA,Jing Z.CollaboratorsOutcomes of intracorporeal urinary diversion after robot-assisted radical cystectomy: results from the international robotic cystectomy consortium.J Urol2018;199:1302-11

[6] Hayn MH,Mansour AM.The learning curve of robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium.Eur Urol2010;58:197-202

[7] Leow JJ,Trinh QD.Impact of surgeon volume on the morbidity and costs of radical cystectomy in the USA: a contemporary population-based analysis.BJU Int2015;115:713-21

[8] Murthy PB,Lee BH.Robotic radical cystectomy with intracorporeal urinary diversion: beyond the initial experience.Transl Androl Urol2020;9:942-8 PMCID:PMC7214984

[9] Tyritzis SI,Collins J.Oncologic, functional, and complications outcomes of robot-assisted radical cystectomy with totally intracorporeal neobladder diversion.Eur Urol2013;64:734-41

[10] Lenfant L,Campi R.Perioperative outcomes and complications of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy for bladder cancer: a real-life, multi-institutional french study.World J Urol2018;36:1711-8

[11] Hussein AA,Aldhaam NA.A comparative propensity score-matched analysis of perioperative outcomes of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium.BJU Int2020;126:265-72

[12] Hautmann RE,Davidsson T.ICUD-EAU International Consultation on bladder cancer 2012: urinary diversion.Eur Urol2013;63:67-80

[13] Novara G,Wilson T.Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy.Eur Urol2015;67:376-401

[14] Zhang JH,Thomas LJ.Large single institution comparison of perioperative outcomes and complications of open radical cystectomy, intracorporeal robot-assisted radical cystectomy and robotic extracorporeal approach.J Urol2020;203:512-21

[15] Shim JS,Rha KH.Do patients benefit from total intracorporeal robotic radical cystectomy? : a comparative analysis with extracorporeal robotic radical cystectomy from a Korean multicenter study.Investig Clin Urol2020;61:11-8 PMCID:PMC6946824

[16] Ericson KJ,Zhang JH.Uretero-enteric anastomotic stricture following radical cystectomy: a comparison of open, robotic extracorporeal, and robotic intracorporeal approaches.Urology2020;144:130-5

[17] Goh AC,Patel NA.A population-based study of ureteroenteric strictures after open and robot-assisted radical cystectomy.Urology2020;135:57-65

[18] Ahmadi N,Hartman N.Use of indocyanine green to minimise uretero-enteric strictures after robotic radical cystectomy.BJU Int2019;124:302-7

[19] Shen JK,Yuh BE.Real-time indocyanine green angiography with the SPY fluorescence imaging platform decreases benign ureteroenteric strictures in urinary diversions performed during radical cystectomy.Ther Adv Urol2019;11:1756287219839631 PMCID:PMC6452578

[20] Feng D,Yang Y,Wei W.Intracorporeal versus extracorporeal urinary diversion after robotic-assisted radical cystectomy: evidence from a systematic review and pooled analysis of observational studies.Minerva Urol Nefrol2020;72:519-30

[21] Ahmed K,Hayn MH.Analysis of intracorporeal compared with extracorporeal urinary diversion after robot-assisted radical cystectomy: results from the International Robotic Cystectomy Consortium.Eur Urol2014;65:340-7

[22] Semerjian A,Kates M.Hospital charges and length of stay following radical cystectomy in the enhanced recovery after surgery era.Urology2018;111:86-91

[23] Mazzone E,Beato S.Robot-assisted radical cystectomy with intracorporeal urinary diversion decreases postoperative complications only in highly comorbid patients: findings that rely on a standardized methodology recommended by the European Association of Urology Guidelines.World J Urol2021;39:803-12

[24] Obrecht F,Burkhardt O.Robot-assisted radical cystectomy and intracorporeal orthotopic neobladder: 1-year functional outcomes.Asian J Androl2020;22:145-8 PMCID:PMC7155788

[25] Mistretta FA,Collà Ruvolo C.Robot-assisted radical cystectomy for nonmetastatic urothelial carcinoma of urinary bladder: a comparison between intracorporeal versus extracorporeal orthotopic ileal neobladder.J Endourol2021;35:151-8

[26] Balbay MD,Kiremit MC.Intracorporeal Studer Pouch Formation with Balbay's Technique following robotic radical cystectomy for bladder cancer: experience with 22 cases with oncologic and functional outcomes.J Endourol2020;34:273-80

[27] Tuderti G,Brassetti A.Robot-assisted radical cystectomy with intracorporeal neobladder: impact of learning curve and long-term assessment of functional outcomes.Minerva Urol Nefrol2020;

[28] Lin TX,Xu KW.Laparoscopic radical cystectomy with orthotopic ileal neobladder: report of 108 cases.Zhonghua Yi Xue Za Zhi2008;88:2437-40

[29] Canda AE,Altinova S,Balbay MD.Robot-assisted nerve-sparing radical cystectomy with bilateral extended pelvic lymph node dissection (PLND) and intracorporeal urinary diversion for bladder cancer: initial experience in 27 cases.BJU Int2012;110:434-44

[30] Grimm T,Buchner A.Health-related quality of life after radical cystectomy and ileal orthotopic neobladder: effect of detailed continence outcomes.World J Urol2019;37:2385-92

[31] De Sutter T,Albersen M.The N-shaped orthotopic ileal neobladder: functional outcomes and complication rates in 119 patients.Springerplus2016;5:646 PMCID:PMC4870512

[32] Kretschmer A,Buchner A.Prognostic features for objectively defined urinary continence after radical cystectomy and ileal orthotopic neobladder in a contemporary cohort.J Urol2017;197:210-5

[33] Meyer JP,Boorer J,Persad R.A three-centre experience of orthotopic neobladder reconstruction after radical cystectomy: initial results.BJU Int2004;94:1317-21

[34] Muto G,Simone G.Stapled orthotopic ileal neobladder after radical cystectomy for bladder cancer: functional results and complications over a 20-year period.Eur J Surg Oncol2016;42:412-8

[35] Hautmann RE,Egghart G.Functional outcome and complications following ileal neobladder reconstruction in male patients without tumor recurrence. More than 35 years of experience from a single center.J Urol2021;205:174-82