Postoperative urinary function recovery after complete robotic assisted radical cystectomy and in situ U-shaped ileal neobladder

Objective To investigate postoperative urinary function recovery after complete robotic assisted radical cystectomy and in situ U-shaped ileal neobladder. Methods Retrospective analysis of 79 cases of local progression bladder cancer (cT2-3N0-2M0) in our hospital from September 2014 to September 2018. 79 cases were confirmed by pathology as high-grade uroepithelium cell carcinoma of bladder. Posterior urethra and bladder neck biopsy did not see tumor invasion.The urodynamic examination for all patients before surgery showed no significant decrease in urinary control function. Preoperative International urinary Incontinence Advisory Committee urinary Incontinence Questionnaire summary confirmed that there was no obvious urinary incontinence symptoms. All patients underwent radical bladder resection and in situ U-shaped ileum new bladder surgery. 40 cases in the experimental group were treated with complete robot assisted radical bladder resection and in situ U-shaped ileum new bladder. 39 cases in control group were treated with laparoscopic surgery. There was no statistically significant difference between the two groups of general data (both P>0.05). The operation time, bleeding volume, positive rate of postoperative incision, postoperative hospitalization time, new bladder capacity, residual urine volume, maximum urinary flow rate, bladder internal pressure, unilateral ureteral reflux and stenosis incidence, as well as immediate urinary control rate after extraction of catheter and 1, 3, 6 and 12 months of urinary control recovery were compared. Results 79 cases of this study were successfully completed. The operation time of the two groups [(286.5±37.2) min vs.(288.5±32.9) min, P=0.801], intraoperative blood loss[(185.1±41.6)ml vs.(189.3±54.2)ml, P=0.700]. There was no significant difference in the average postoperative hospital stay [(14.3±1.6)d vs.(14.9±2.2)d, P=0.168]. The margins of the pathological examinations in both groups were negative. New bladder volume after surgery [(300±10)ml vs.(245±10)ml, P 0.05). Conclusions Complete robot-assisted radical cystectomy and in situ U-shaped ileal neobladder surgery are more advantageous than standard laparoscopic surgery in time of the early recovery urinary function. Key words: Bladder neoplasms; Complete robotic assist; Total cystectomy; In situ U-shaped neobladder; Urinary control