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The following is a summary of “Salvage robotic-assisted radical cystectomy is safe in patients with history of pelvic irradiation,” published in the April 2025 issue of Current Urology by Kovacic et al. 

Researchers conducted a retrospective study to evaluate the surgical approach and perioperative outcomes of robotic-assisted radical cystectomy with total intracorporeal urinary diversion in patients with prior pelvic radiotherapy. 

They analyzed a prospective cystectomy database for patients who underwent robotic-assisted radical cystectomy after radiotherapy between 2018 and 2022. They collected demographics and preoperative data, including disease stage, hydronephrosis, and radiotherapy history, from electronic records. All surgeries were done by 1 of 2 urologists using da Vinci X, Xi, or Si systems. 

The results showed 10 patients were included with a median age of 73.5 years (range 41–84). Median ASA score was 3 (range 3–4), and Charlson Comorbidity Index was 6 (range 2–12). About 4 patients (40%) had muscle-invasive bladder cancer, 8 underwent intracorporeal ileal conduit, and 2 had neobladder formation. Median blood loss was 250 mL (range 150–600), and operative time was 390 minutes (range 195–450). The 30-day complication rate was 60%, with 15% experiencing Clavien-Dindo grade 3 or higher complications. Perioperative mortality was 0%. Median follow-up was 210 days (range 60–1,580). 

Investigators demonstrated the safety of salvage robotic-assisted radical cystectomy with total intracorporeal urinary diversion. They recommended further studies with long-term follow-up to support broader adoption. 

Source: journals.lww.com/cur/fulltext/9900/salvage_robotic_assisted_radical_cystectomy_is.196.aspx