ĐÁNH GIÁ AN TOÀN PHẪU THUẬT NỘI SOI CÓ ROBOT HỖ TRỢ CẮT BÀNG QUANG TẬN GỐC TẠO HÌNH BÀNG QUANG TRỰC VỊ

Abstract

Introdution: Radical cystectomy with orthotopic neobladder reconstruction is a highly intricate surgical procedure, impacting both the urogenital and gastrointestinal systems. We conducted a prospective assessment of 90-day postoperative mortality and morbidity following robot-assisted radical cystectomy (RARC) using a standardized reporting approach (Clavien–Dindo classification). Methods: Our prospective analysis involved patients undergoing robot-assisted radical cystectomy with orthotopic neobladder reconstruction between November 2020 and October 2022 at Binh Dan Hospital. Postoperative complications within the 90-day period were meticulously documented and categorized based on the modified Clavien–Dindo classification. Results: Among the 48 patients studied, 52 postoperative complications were detected in 23 patients (47.9%). Of these incidents, 9 (17.3%) were categorized as high grade (Grade III or above) and manifested in 8 patients (16.6%). Common complications included urinary tract infections (43.8%), wound complications (10.4%), and paralytic ileus (25.0%). Furthermore, 3 out of 48 patients (6.25%) undergoing intestinal urinary diversion developed ureteroenteric stricture, 2 cases (4.17%) resulted in intestinal neobladder fistula, and 1 case (2.08%) presented gastrointestinal-bowel obstruction. The mean intraoperative blood loss was 335.6ml, mean operative time was 378 minutes, and mean hospital stay was 6.4 days. Conclusions: Most complications after surgery are low grade. However, for all patients who have undergone orthotopic neobladder reconstruction, we recommend closed monitoring, early detection of complications and timely treatment.