Investig Clin Urol.  2017 May;58(3):171-178. 10.4111/icu.2017.58.3.171.

A preliminary oncologic outcome and postoperative complications in patients undergoing robot-assisted radical cystectomy: Initial experience

• Muto S
• Kitamura K
• Ieda T
• Shimizu F
• Nagata M
• Isotani S
• Ide H
• Yamaguchi
• Horie S

• KMID: 2388061
• DOI: http://doi.org/10.4111/icu.2017.58.3.171

Abstract

PURPOSE
Robot-assisted radical cystectomy (RARC) was originally intended to replace open radical cystectomy (ORC) as a minimally invasive surgery for patients with invasive bladder cancer. The purpose of this study was to evaluate the advantages of robotic surgery, comparing perioperative and oncologic outcomes between RARC and ORC.
MATERIALS AND METHODS
Between June 2012 and August 2016, 49 bladder cancer patients were given a radical cystectomy, 21 robotically and 28 by open procedure. We compared the clinical variables between the RARC and ORC groups.
RESULTS
In the RARC group, the median estimated blood loss (EBL) during cystectomy, total EBL, operative time during cystectomy, and total operative time were 0 mL, 457.5 mL, 199 minutes, and 561 minutes, respectively. EBL during cystectomy (p<0.001), total EBL (p<0.001), and operative time during cystectomy (p=0.003) in the RARC group were significantly lower compared with the ORC group. Time to resumption of a regular diet (p<0.001) and length of stay (p=0.017) were also significantly shorter compared with the ORC group. However, total operative time in the RARC group (median, 561 minutes) was significantly longer compared with the ORC group (median, 492.5 minutes; p=0.015).
CONCLUSIONS
This Japanese study presented evidence that RARC yields benefits in terms of BL and time to regular diet, while consuming greater total operative time. RARC may be a minimally invasive surgical alternative to ORC with less EBL and shorter length of stay.

Keyword

Cystectomy; Robotics; Urinary bladder neoplasms

MeSH Terms

Asian Continental Ancestry Group
Cystectomy*
Diet
Humans
Length of Stay
Minimally Invasive Surgical Procedures
Operative Time
Postoperative Complications*
Robotics
Urinary Bladder Neoplasms

Figure

• 

  Fig. 1 Kaplan-Meier estimated survival between RARC and ORC. There are no significant differences in PFS (p=0.732; A) and OS (p=0.401; B) between the RARC (mean: PFS, 37.4 months; OS, 40.2 months) and ORC groups (mean: PFS, 30.9 months; OS, 34.8 months). RARC, robot-assisted radical cystectomy; ORC, open radical cystectomy; PFS, progression-free survival; OS, overall survival.

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