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The following is a summary of “Robotic surgery of the urothelial carcinoma of the upper urinary tract single surgeon initial experience, 66 consecutive cases,” published in the November 2024 issue of Urology by Farzat et al. 

Robotic surgery is a growing treatment option for upper urinary tract urothelial carcinoma (UTUC). 

Researchers conducted a retrospective study to analyze the benefits and challenges of robot-assisted surgery for UTUC, focusing on functional and oncologic outcomes. 

The study included 66 patients treated by a single robotic surgeon from July 2019 to December 2023. Patients were grouped by procedure: RANU with bladder cuff excision (50), RANU with RARC (11), and RASU (5). Clinical and oncological parameters were compared, with perioperative morbidity (Clavien-Dindo) as the primary endpoint and oncologic outcomes as the secondary. 

The results showed that 37.8% of patients had locally advanced carcinoma. The average console time for RANU with bladder cuff excision was 69 minutes, with positive margins in (n = 1/66; 2%). Lymphadenectomy (LAD) was performed in 30% of patients, removing an average of 13.7 nodes; 33% had lymph node metastasis. Blood transfusions were given to (n = 6/66; 9%), overall complications were 24%, and readmissions were 7.5%. With a median follow-up of 26 months, the 2-year recurrence-free survival was 84.4%, and overall survival was 94%. 

The study concluded that robotic surgery was a viable option for treating UTUC, adaptable to individual patient needs, and further prospective studies were needed to confirm its benefits. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01629-y