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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2021

01-12-2021 | Cystectomy | Urologic Oncology

Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion

Authors: Jeremy Yuen-Chun Teoh, FRCSEd, Erica On-Ting Chan, MBChB, Seok-Ho Kang, MD, Manish I. Patel, MBBS, PhD, Satoru Muto, MD, PhD, Cheng-Kuang Yang, MD, Shingo Hatakeyama, MD, PhD, Timothy Shing-Fung Chow, MBChB, Alex Mok, MBChB, Ruiyun Zhang, PhD, Kittinut Kijvikai, MD, Lui-Shiong Lee, MBBS, MRCS, MMed, Haige Chen, PhD, Chikara Ohyama, MD, PhD, Shigeo Horie, MD, PhD, Eddie Shu-Yin Chan, FRCSEd

Published in: Annals of Surgical Oncology | Issue 13/2021

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Abstract

Purpose

This study was designed to investigate and compare the perioperative outcomes of intracorporeal urinary diversion (ICUD) versus extracorporeal urinary diversion (ECUD) following robotic-assisted radical cystectomy (RARC) in patients with localized bladder cancer from the Asian Robot-Assisted Radical Cystectomy (RARC) Consortium.

Methods

The Asian RARC registry was a multicenter registry involving nine centers in Asia. Consecutive patients who underwent RARC were included. Patient and disease characteristics, intraoperative details, and perioperative outcomes were reviewed and compared between the ICUD and ECUD groups. Postoperative complications were the primary outcomes, whereas secondary outcomes were the estimated blood loss and the duration of hospitalization. Multivariate regression analyses were performed to adjust potential confounders.

Results

From 2007 to 2020, 556 patients underwent RARC; 55.2% and 44.8% had ICUD and ECUD, respectively. ICUD group had less estimated blood loss (423.1 ± 361.1 vs. 541.3 ± 474.3 mL, p = 0.002) and a shorter hospital stay (15.7 ± 12.3 vs 17.8 ± 11.6 days, p = 0.042) than the ECUD group. Overall complication rates were similar between the two groups. Upon multivariate analysis, ICUD was associated with less estimated blood loss (Regression coefficient: − 143.06, 95% confidence interval [CI]: − 229.60 to − 56.52, p = 0.001) and a shorter hospital stay (Regression coefficient: − 2.37, 95% CI: − 4.69 to − 0.05, p = 0.046). In addition, ICUD was not associated with any increased risks of minor, major, and overall complications.

Conclusions

RARC with ICUD was safe and technically feasible with similar postoperative complication rates as ECUD, with additional benefits of reduced blood loss and a shorter hospitalization.
Appendix
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Metadata
Title
Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion
Authors
Jeremy Yuen-Chun Teoh, FRCSEd
Erica On-Ting Chan, MBChB
Seok-Ho Kang, MD
Manish I. Patel, MBBS, PhD
Satoru Muto, MD, PhD
Cheng-Kuang Yang, MD
Shingo Hatakeyama, MD, PhD
Timothy Shing-Fung Chow, MBChB
Alex Mok, MBChB
Ruiyun Zhang, PhD
Kittinut Kijvikai, MD
Lui-Shiong Lee, MBBS, MRCS, MMed
Haige Chen, PhD
Chikara Ohyama, MD, PhD
Shigeo Horie, MD, PhD
Eddie Shu-Yin Chan, FRCSEd
Publication date
01-12-2021
Publisher
Springer International Publishing
Keyword
Cystectomy
Published in
Annals of Surgical Oncology / Issue 13/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-10295-5

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