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Radical cystectomy in bladder cancer: complications, prognosis, history of the method

The article is a review of domestic and foreign literature sources covering the development of complications and long-term prognoses during radical cystectomy, as well as the history of the development of the method. The gold standard for the treatment of muscle invasive bladder cancer (MIBC) is radical cystectomy with bilateral pelvic lymph node dissection. The high incidence of intra- and postoperative complications, as well as a large number of repeat visits (up to 25 %) in the first 30 days after open radical cystectomy necessitates a search and implementation of new methods of surgical treatment, one of which is robotic-assisted radical cystectomy (RARC). The robotic method reduces the need for intra- and postoperative blood transfusion, but does not significantly improve the patient’s quality of life compared to open surgery. The main disadvantage of the RARС is the long operation time. Urinary drainage is a necessary component of radical cystectomy. The most modern methods of derivation are «dry» stoma placement and orthotopic bladder surgery with urination along the native urethra. However, the choice of urinary drainage must be made based on a number of factors, including the patient’s comorbidities, surgical feasibility, postoperative care capacity, and patient preference.