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World Journal of Urology

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01-12-2024 | Cystectomy | Original Article

Perioperative complications and oncological outcomes of open versus robotic-assisted radical cystectomy: a propensity score-matched study

Authors: Peter Hanna, Joseph Zabell, Badrinath Konety, Christopher Warlick

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

To conduct a comparative effectiveness analysis between robot-assisted radical cystectomy (RARC) and open approach (ORC).

Materials and methods

A retrospective cohort study was conducted involving all patients undergoing radical cystectomy and urinary diversion for invasive bladder cancer at our institution from 2010 to 2018. Of a total 296 patients, we matched ORC and RARC cases based on age, BMI, Charlson comorbidity index, pathological TN staging of the tumor, prior radiotherapy, and type of diversion. The perioperative complications and oncological outcomes were compared.

Results

Eighty-nine patients were matched in the ORC and RARC groups. The median operative time was longer in RARC group (430 min) than that of ORC group (372 min) (p = 0.03); however, the median estimated blood loss (EBL) was significantly lower in RARC group (500 ml) than that of ORC (700 ml) (p < 0.0001). The median length of hospital stay (LOS) was significantly reduced in the RARC group (7 days) compared to the ORC group (8 days) (p = 0.02). There were no significant differences between both groups in 30- and 90-day postoperative complications (p = 0.3 and p = 0.2, respectively). A total of 68 deaths (38.2%) were observed, of which 36 (40.4%) were in ORC group while 32 (36%) were in RARC group (p = 0.5). The results were comparable in both groups regarding 5-year survival rate and cancer-specific survival (p = 0.3 and p = 0.1, respectively).

Conclusion

RARC showed better perioperative outcomes in the form of less EBL and shortened LOS compared to ORC group. However, both RARC and ORC provide similar postoperative oncologic control, in terms of similar positive surgical margins, cancer-specific rates, and 5-year survival rates.

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Title: Perioperative complications and oncological outcomes of open versus robotic-assisted radical cystectomy: a propensity score-matched study
Authors: Peter Hanna
Joseph Zabell
Badrinath Konety
Christopher Warlick
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keyword: Cystectomy
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04907-4

At a glance: The STEP trials

Springer Medicine

Perioperative complications and oncological outcomes of open versus robotic-assisted radical cystectomy: a propensity score-matched study

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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