Robot-assisted radical cystectomy for non-metastatic urothelial carcinoma of urinary bladder: a comparison between intracorporeal versus extracorporeal orthotopic ileal neobladder.

Introduction To compare surgical, oncologic, functional outcomes and complication rate between intracorporeal (ICNB) and extracorporeal (ECNB) orthotopic ileal neobladder at robot-assisted radical cystectomy (RARC) in patients with non-metastatic bladder carcinoma (BC). Materials and Methods From 2014 to 2019 we prospectively collected and retrospectively analysed 101 patients with non-metastatic BC treated with RARC and ortothopic neobladder. Chi-squared test estimated differences in proportions of functional and oncologic outcomes. Multivariable logistic regression models (MLRMs) focused on overall, early ( 30 days from discharge) in ICNB vs. ECNB. Results Of all patients, 57 (56.4%) ICNB and 44 (43.6%) ECNB patients were identified. At least one complication occurred in 75.4 vs. 72.7% in ICNB vs. ECNB respectively (p = 0.9). In MLRMs, focusing on complication rate there was not statically significant difference between ICNB vs. ECNB for overall (p = 0.8), early (p = 0.6) and late complications (p = 0.8). No statistically significant differences were recorded for tumour relapse rate, cancer specific and other cause mortality. No positive surgical margins were recorded in both groups. Daytime and nighttime continence recovery were 89.4 vs. 87.1% (p = 1.0) and 63.8 vs. 51.6% (p = 1.0) for ICNB vs. ECNB. Potency recovery was 59.1 vs. 54.3% (p = 0.5) for ICNB vs. ECNB. Conclusions No statistically significant differences in complication rate (overall, early or late) were identified, when ICNB and ECNB were compared. Similarly, no statistically significant difference was found in oncologic and functional outcomes.