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Actas Urológicas Españolas. 2011;35(3):158
ACTAS
Actas Urológicas Españolas
Revista Oficial de la AEU y de la CAU
ACTAS
Urológicas Españolas
Volumen 35. Número 1.
Enero 2011.
Nicturia y caídas en ancianos
Criterios y exactitud de la biopsia
de próstata
PSA y NF-kB en próstata
Linfadenectomía retroperitoneal
laparoscópica
Ureteroneocistostomía laparoscópica
Enucleación prostática con láser diodo
Retrasplante renal
Ureterocalicostomia
Ureterolitotomía transumbilical
Edición electrónica:
Free Full Text Español/Inglés
Ácido hialurónico intravesical
Sunitinib y cáncer de próstata
www.elsevier.es/actasuro
EDITORIAL COMMENT
Comment to: ‘‘Robotic-assisted laparoscopic radical cystectomy:
evaluation of functional and oncological results”
Comentario a: «Cistectomía radical laparoscópica asistida por robot:
evaluación de los resultados funcionales y oncológicos»
J. Palou
Unidad de Urología Oncológica, ESU. Fundació Puigvert, Universidad Autónoma de Barcelona, Spain
Radical cystectomy is the standard treatment for muscleinvasive bladder cancer, and no exception to the application
of less invasive surgical options. Yet only the strict
evaluation of performance, morbidity, functional and
oncological results will allow identifying its real benefit
within the armamentarium available, which is why in
the European guidelines suggest that robotic-assisted
laparoscopy may be an option, but does not yet establish it
as a consolidated technique.1
Robotics, such as laparoscopic surgery, has shown a
noticeable decrease in bleeding in radical pelvic urological
surgery in both prostate and bladder surgery. The overall
experience of the series currently being published point
at certain results, despite including the learning curve of
each group, which are totally comparable to, if not better
than, open radical surgery. Today, the most experienced
group is the International Robotic Cystectomy Consortium
(IRCC), which has studied more than 500 cystectomies and
shows the variability of various parameters according to
the surgeon’s experience (time, bleeding, number of lymph
nodes, surgical complications2) but with good results in all
parameters and a relatively short learning curve compared
with laparoscopic prostate surgery.
In this initial series, it is worth mentioning the prolonged
hospital stay of 17.7 days, and considerable morbidity with
Clavien 3 or higher complications in 11.9%, although similar
to traditional open surgery series.3
Although at present we are awaiting the long-term
oncological results, initial results appear to be similar to
open surgery series. On the other hand, the first functional
results seem to show encouraging results in favor of this
minimally invasive surgery.4
References
1. Palou J, Gaya JM, Breda A, Rodríguez O, Villavicencio H. Robotic
Cystectomy Versus Open Cystectomy: Are we there yet? Eur
Urol. 2010;Suppl 9:433-7.
2. Hayn MH, Hussain A, Mansour AM, Andrews PE, Carpentier P,
Castle E, et al. The learning curve of robot-assisted radical
cystectomy: results from the International Robotic Cystectomy
Consortium. Eur Urol. 2010;58:203-4.
3. Treiyer A, Saar M, Kopper B, Kamradt J, Siemer S, Stöckle M.
Cistectomía radical laparoscópica asistida por robot: evaluación de los resultados funcionales y oncológicos. Actas Urol Esp.
2011;35:153-7.
4. Palou J, Gaya JM, Gausa LL, Sánchez-Martín F, Rosales BA,
Rodríguez FO.Cistoprostatectomía radical robótica: análisis
oncológico y funcional. Actas Urol Esp. 2009;33:759-66.
E-mail: [email protected]
0210-4806/$ - see front matter © 2010 AEU. Published by Elsevier España, S.L. All rights reserved.