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Ornaghi et al. Mini-invasive Surg 2021;5:42  https://dx.doi.org/10.20517/2574-1225.2021.50                                                                               Page 7 of 17



                                                                                                            female/44)                           according to CCS;       The TTF and bowel movement was about 3 days
                                                                                                                                                 - Pathological: pT stage,   (P = 0.38), and LOS was about 18 days (20 in
                                                                                                                                                 pN stage, PSMs, LN yield,   female, 17.7 in male, P = 0.19)
                                                                                                                                                 histology;              The mean LN yield removed were 18 (16.0 in
                                                                                                                                                 - Oncological: DFS      female, 19.1 in male, P = 0.32), and 10 patients
                                                                                                                                                                         had node metastatic disease on final pathologic
                                                                                                                                                                         evaluation. Postoperative complications
                                                                                                                                                                         occurred in 28 (26.9%) patients, major
                                                                                                                                                                         complications in 8 (7.7%) patients, and minor
                                                                                                                                                                         complications in 20 (19.2%) patients
                                       [19]
                              Pruthi et al.  ,   Retrospective   50 (40 male, 10  RARC          Median of 14  IC (7         Age, sex, BMI,       - Surgical: OT, type of UD,  Female patients had shorter OT (4.6 h vs. 5.9 h,
                              2009              (monocentric    female)                         months (IQR  female/30);    preoperative TNM     EBL, TTF, LOS, 30-day   P < 0.001), less EBL (215 mL vs. 330 mL, P =
                                                study)                                          0.2-73)     ONB (3                               complications;          0.012) and approached a shorter time to bowel
                                                                                                            female/20)                           - Pathological: pT stage,   movement (2.4 days vs. 2.8 days, P = 0.057).
                                                                                                                                                 pN stage, PSMs, LN yield  Mean TTF was 1.9 days (vs. 2.2 days), and mean
                                                                                                                                                                         LOS was 4.9 days vs. 4.4 days). These outcomes
                                                                                                                                                                         were comparable to the male patients,
                                                                                                                                                                         particularly the 20 male patients undergoing
                                                                                                                                                                         RARC during the same time period
                                                                                                                                                                         On surgical pathology, 5 patients were ≤ pT2 (
                                                                                                                                                                         vs. 28), 3 patients pT3 (vs. 6), and 2 patients N+
                                                                                                                                                                         (s 6). There were no PSMs. Mean number of LN
                                                                                                                                                                         removed was 19 (IQR 12-34), vs. 18 (IQR 8-37).
                                                                                                                                                                         Males were more often organ confined in our
                                                                                                                                                                         series (70% vs. 50%), but node-positive rates
                                                                                                                                                                         were not significantly different (15% vs. 20%)
                                                                                                                                                                         In female patients, 30-day complications
                                                                                                                                                                         included 2 complications in 2 patients.
                                                                                                                                                                         Complication rates in the male cohort was 30%,
                                                                                                                                                                         but this was not found to be statistically different
                                                                                                                                                                         than the rate in females


                             RC: Radical cystectomy; RARC: robot-assisted radical cystectomy; SS-RARC: sex-sparing-robot-assisted radical cystectomy; ORC: open radical cystectomy; LRC: laparoscopic radical cystectomy; IQR: interquartile
                             range; iN: intracorporeal neobladder; BMI: body mass index; ASA: American society of anesthesiologists; OT: operative time; Hb: hemoglobin; LOS: length of hospital stay; CCS: Clavien-Dindo classification system;
                             AC: adjuvant chemotherapy; NAC: neoadjuvant chemotherapy; PSMs: positive surgical margins; UES: uretero-enteric strictures; CIC: clean intermittent catheterization; FSFI: female sexual function index; CKD:
                             chronic kidney disease; QoL: quality of life; NR: not reported; UD: urinary diversion; ICUD: intracorporeal urinary diversion; ECUD: extracorporeal urinary diversion; CCI: Charlson comorbidity index; EBL: estimated
                             blood loss; IT: intraoperative transfusion; PT: postoperative transfusion; OR: odds ratio; CI: confidence interval; LN: lymph node; ONB: orthotopic neobladder; IC: ileal conduit; CCD: continent cutaneous diversion;
                             IPC: Indiana pouch; RFS: recurrence-free survival; OS: overall survival; DFS: disease-free survival; UTI: urinary tract infection; RT: radiotherapy; ICU: intensive care unit; LVI: lymphovascular invasion; TURBT:
                             transurethral resection of bladder tumour; TTF: time to flatus; OS: overall survival; CSS: cancer-specific survival; CIS: cancer in situ; GS: Gleason Score; PLND: pelvic lymph node dissection; IIEF: international index of
                             erectile function; PDE5-I: phosphodiesterase type 5 inhibitors.



                             All articles collected dealt with female patients undergoing RARC. In three of these studies, the technique applied was NS                        [13,21,22] , specifically to safeguard
                             functional postoperative outcomes. One article also included ORC, comparing the outcomes of the two approaches .
                                                                                                                                                                 [18]
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