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Robotic-assisted Laparoscopic Management of Bladder/Prostate Rhabdomyosarcoma in Children: Initial Series and 1-yr Outcomes.

OBJECTIVE
To present our preliminary experiences of robotic-assisted laparoscopic radical or partial cystectomy for bladder/prostate rhabdomyosarcoma in children.


METHODS
A retrospective study was conducted with children who underwent robotic-assisted laparoscopic surgery for bladder/prostate rhabdomyosarcoma (B/P RMS) between July 2018 and March 2020. The patient characteristics, tumor position, perioperative information, short time oncologic survival outcomes, and urinary function were recorded and evaluated.


RESULTS
We identified eight children who underwent robotic-assisted laparoscopic surgery for B/P RMS. Partial cystectomy was performed on all but one patient, who underwent a radical cystectomy and sigmoid neobladder reconstruction. Preoperative chemotherapy was administered to all eight patients, while preoperative radiotherapy was conducted in three cases, including one patient with a history of pelvic rhabdomyosarcoma. Unilateral/bilateral ureter reimplantation was done in four cases in which the patients' ureter orifices were involved. The mean follow-up time was 13.3 months, and no local recurrence or metastasis was observed. No patient experienced urinary incontinence eventually.


CONCLUSION
Robotic-assisted laparoscopic resection for bladder rhabdomyosarcoma in children is safe and feasible. Preoperative radiotherapy could decrease the tumor volume so that the membranous urethra could be preserved for as long as possible. The oncological efficacy and overall survival rate require further investigation and longer follow-up.