Preliminary experience of robotic-assisted laparoscopic surgery for bladder rhabdomyosarcoma in children / 中华泌尿外科杂志

ABSTRACT

Objective:To evaluate the safety and feasibility of robotic-assisted laparoscopic resection of bladder rhabdomyosarcoma.Methods:A retrospective study was performed in 4 children underwent robotic-assisted surgery for bladder rhabdomyosarcoma from July 2018 to September 2019 in our hospital. The perioperative information and short time outcomes were collected. All the four patients were male. The average age of these patients was 68 months (from 11 to 122 months). After cystoscopy biopsy was conducted, preoperative chemotherapy was carried out. Preoperative radiotherapy was also added depends on the tumor response, then robotic-assisted surgery was performed. Radical cystectomy and orthotopic neobladder reconstruction with bilateral ureter reimplanataion were carried out for the bladder was widely occupied case. Bladder preserving surgery was performed for the other three localized cases.Results:All of the four operations have been conducted successfully without conservation to open surgery. The mean operative time was 189(104-316) min while the mean estimated blood loss was 32.5(20-50) ml. The mean tumor diameter was 4.48(2.7-6.0)cm. According to the pathological results, all of the four cases were diagnosed as embryonal rhabdomyosarcoma. One case had positive margin while other three cases had negative margins. No complication more than Clavien-Dindo grade Ⅲ was observed. The mean length of hospital stay was 18(14-24)days and the mean follow-up time was 14.7(7-21) months. Postoperative chemotherapy was carried out according to the protocol of IRS low risk group for all cases (VAC, eight cycles). Postoperative radiotherapy was conducted for the case with positive margin. No recurrence was recorded during the follow-up period.Conclusions:Robotic-assisted laparoscopic technique for the treatment of bladder rhabdomyosarcoma in children is safe and feasible.