Robot-assisted Laparoscopic Implantation of Brachytherapy Catheters in Bladder Cancer

• Published in: European urology 2018-09, Vol.74 (3), p.369-375
• Main Authors: Bosschieter, Judith, Vis, André N, van der Poel, Henk G, Moonen, Luc M, Horenblas, Simon, van Rhijn, Bas W.G, Pieters, Bradley R, Nieuwenhuijzen, Jakko A, Hendricksen, Kees
• Format: Article
• Language: English
• Subjects: Bladder-preserving therapy; Brachytherapy; robotic surgical procedures; Urinary bladder neoplasm; Urology
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2017.05.054

Abstract Background Robot-assisted laparoscopic (RAL) implantation of brachytherapy catheters (BTCs) can be a minimally invasive alternative to open retropubic implantation. Descriptions of the surgical technique and outcomes are sparse. Objective To describe our technique and perioperative outcomes for RAL BTC implantation in urothelial carcinoma (UC) and urachal carcinoma (UraC). Design, setting and participants Between June 2011 and May 2016, 26 patients with cN0M0 solitary T1G3 or T2G1–3 UC of ≤5 cm or cN0M0 UraC were scheduled for external beam radiotherapy (20 × 2 Gy), RAL BTC implantation, and pulsed-dose (29 × 1.04 Gy) or high-dose rate brachytherapy (10 × 2.50 Gy). Median follow-up was 12 mo (interquartile range 4–20). Surgical procedure RAL BTC implantation with or without pelvic lymph node dissection and/or partial cystectomy. Measurements and statistical analysis Perioperative data, complications, disease-free-survival (DFS), local recurrence-free survival (LRFS), and cystectomy-free survival (CFS) were evaluated as well as the feasibility of the technique. Results and limitations BTC implantation was successful in 92% of the patients. Median hospitalisation was 5 d (interquartile range 4–7) and blood loss