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Jing S, Yang E, Luo Z, Zhang Y, Ding H, Yang L, Dong Z, Shang P, Yue Z, Wu G, Bao J, Tian J, Wang J, Xiao N, Wang Z. Perioperative outcomes and continence following robotic-assisted radical cystectomy with mainz pouch II urinary diversion in patients with bladder cancer. BMC Cancer 2024; 24:127. [PMID: 38267934 PMCID: PMC10809619 DOI: 10.1186/s12885-024-11874-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE To present the widely unknown perioperative outcomes and continence status of bladder cancer patients following robotic-assisted radical cystectomy (RARC) with Mainz pouch II urinary diversion (UD). MATERIALS AND METHODS From November 2020 to December 2023, 37 bladder cancer patients who underwent RARC with Mainz pouch II UD were retrospectively assessed (ChiCTR2300070279). The results, which included patient demographics, perioperative data, continence, and complications (early ≤ 30 days and late ≤ 30 days) were reported using the RC-pentafecta criteria. RC-pentafecta criteria included ≥ 16 lymph nodes removed, negative soft tissue surgical margins, absence of major (Grade III-IV) complication at 90 days, absence of clinical recurrence at ≤ 12 months, and absence of long-term UD-related sequelae. A numeric rating scale assessed patient satisfaction with urinary continence 30 days after surgery. The validated Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire was used to evaluate bowel function. The Kaplan-Meier curve was used to evaluate overall survival (OS). RESULTS Of the 37 patients evaluated over a median (range) follow-up period of 23.0 (12.0-36.5) months. The median (range) age was 65 (40-81) years. The median (range) time to urinary continence after surgery was 2.3 (1.5-6) months. Of the 37 patients, 31 (83.8%) were continent both during the day and at night, 34 (91.9%) were continent during the day, 32 (86.5%) were continent at night, 35 (94.6%) were satisfied with their urinary continence status, and 21 (56.8%) were very satisfied. The mean (range) voiding frequency was 6 (4-10) during the day and 3 (2-5.5) at night. The mean (range) PAC-SYM total score was 9.50 (4.00-15.00). In 12 (32.4%) of the patients, RC-pentafecta was achieved, and achieving RC-pentafecta was linked to better satisfaction scores (7.3 vs. 5.5, p = 0.034). There was no significant difference between RC-pentafecta and No RC-pentafecta groups in terms of OS (25.6 vs. 21.5 months, p = 0.16). 7 (19.4%) patients experienced late complications. CONCLUSIONS Mainz pouch II UD following RARC in bladder cancer patients results in a satisfactory continence rate. Achieving RC-pentafecta was correlated with better satisfaction scores. The intracorporeal approach to Mainz pouch II UD is beneficial for female patients due to its reduced invasiveness. TRIAL REGISTRATION ChiCTR2300070279; Registration: 07/04/2023, Last updated version: 01/06/2023. Retrospectively registered.
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Affiliation(s)
- Suoshi Jing
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
- Department of Urology, The First Hospital of Lanzhou University, 730030, Lanzhou, China
| | - Enguang Yang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Zuoxi Luo
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Yunxin Zhang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Hui Ding
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Li Yang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Zhilong Dong
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Panfeng Shang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Zhongjin Yue
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Gongjin Wu
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Junsheng Bao
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Junqiang Tian
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Jiaji Wang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Nan Xiao
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China
| | - Zhiping Wang
- Institute of Urology, Key Laboratory of Gansu Province for Urological Diseases, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, 730030, Lanzhou, China.
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