Robot-Assisted Urachal Excision and Partial Cystectomy for Urachal Pathologies: Systematic Review with Insights from Single-Center Experience
Bibliographic record
Abstract
Background: Urachal pathologies, while rare, carry a risk of malignant transformation. Robot-assisted urachal excision and partial cystectomy (RAUEPC) is a minimally invasive technique that offers potential advantages, but the available evidence remains limited. This study aims to evaluate the outcomes of RAUEPC for benign and malignant urachal pathologies through a systematic review and single-center experience. Methods: A systematic review was conducted using PubMed, Scopus, the Cochrane Library, and ScienceDirect (last search: 1 November 2024). Inclusion criteria encompassed studies reporting on RAUEPC for urachal pathologies, while non-robotic approaches and incomplete data were excluded. Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and the JBI Critical Appraisal Checklist for Case Reports. Descriptive statistics summarized continuous data (means, medians, 95% confidence intervals), and chi-square tests analyzed associations between categorical variables. Heterogeneity analysis was infeasible, necessitating narrative synthesis. Institutional retrospective data from three cases (2021–2024) were included for comparison. This study was registered in PROSPERO (CRD42024597785). No external funding was received. Results: A total of 44 studies (n = 145) met the inclusion criteria. Benign lesions accounted for 66.2% and malignant lesions for 33.8%. Mean operative time was 177.8 min (cumulative), 162.7 min (benign), 192.2 min (malignant), 85.33 min (institutional, 95% CI: 74.13–96.53). Mean blood loss was 85.4 mL (cumulative), 99.5 mL (benign), 72.7 mL (malignant), 216.66 mL (institutional). Mean hospital stay was 3.64 days (cumulative), 3.26 days (benign), 4.36 days (malignant), 6.33 days (institutional, 95% CI: 3.46–9.20). Complications occurred in 10.04% (cumulative), 11.82% (benign), 8.57% (malignant), with one minor event (Clavien–Dindo II) in institutional cases. No conversions to open surgery were reported. All cases achieved complete excision with no R1 resections. No recurrences were observed at 10.66-month (institutional) mean follow-up. Conclusions: RAUEPC appears to be a feasible and safe approach with promising short-term outcomes. The associations between symptoms and diagnostic methods highlight its utility. The limitations of the evidence include small sample sizes and retrospective designs. Further prospective studies are needed to validate these findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".