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Πέμπτη 8 Απριλίου 2021

Robot‐Assisted Versus Open Radical Cystectomy: A Cohort Study on Perioperative Outcomes Accounting for Stage Selection Bias and Surgical Experience

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Abstract

Background

Most comparisons of robot‐assisted (RARC) versus open radical cystectomy (ORC) for urothelial carcinoma do not factor the inherent stage selection bias or surgical experience.

Methods

We compared the perioperative outcomes of 229 RARC and 335 ORC at a single tertiary referral center with propensity score matching and multiple regression models, when controlling for tumor and patient characteristics, surgeon's experience and type of urinary diversion.

Results

RARC had less major complications (19.8% vs. 34.1%) and ICU admissions (6.6% vs. 19.8%), with lower blood loss (400 vs. 500ml) and transfusion rates. The operating time was longer (336 vs. 286min), but decreased with surgeon's experience. RARC had less PSMs (3% vs. 8.4%) and a higher lymph node count (14 vs. 11).

Conclusions

In this large single center series comparing RARC with ORC controlling for stage selection bias and surgical experience, RARC proved significantly better outcomes, especially with intracorporeal urinary diversion.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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