Comparison of Open Radical Cystectomy vs Robot-Assisted Radical Cystectomy Perioperative Outcomes and Complications at a Single Center: An Analysis of Matched Pairs

Authors : Harun Özdemir, Emin Taha Keskin, Merve Şam Özdemir, Metin Savun, Halil Lütfi Canat, Abdülmüttalip Şimşek

Pages : 61-68

Doi:10.54233/endouroloji.20231502-1290426

View : 29 | Download : 44

Publication Date : 2023-05-31

Article Type : Research Article

Abstract :Objective: The standard curative treatment for non-metastatic high-risk non-muscle-invasive and muscle-invasive bladder cancer is regional pelvic lymphadenectomy (PLND) combined with radical cystectomy. The most prefered surgical procedure is an open radical cystectomy (ORC). However, there are significant risks related to this surgical procedure. Robot-assisted radical cystectomy (RARC), one of the minimally invasive surgical procedures, has been demonstrated to reduce surgical morbidity and boost recovery. In this study, we examined the postoperative complications and outcomes of patients who underwent RARC and ORC for bladder cancer in our clinic using matched pair analysis. Material and Methods: Between January 2021 and February 2023, datas of radical cystectomy patients were collected retrospectivelly at our clinic. Twenty patients who underwent RARC and forty patients who underwent ORC were matched at a ratio of 1:2 for age (± 2 years), gender, clinical TNM stage, and urinary diversion (ileal conduit or orthotopic neobladder) during the same period. The outcomes and complications of perioperative and postoperative procedures have been compared. Results: There was no difference in preoperative data between the two groups. The RARC group had found significantly longer operative times (307.5 versus 391.7 minutes; P=0.001). Patients with RARC group had significantly lower bood-loss (P=0.001) and required less intraoperative blood transfusions (P=0.023). ICU stays were significantly longer in ORC (p =.047). The rates of mild Clavien complications were found to be similar between groups in the postoperative first 90 days. Open surgery was found to be associated with a significantly higher incidence of major (clavien 3-5) complications (p =.042). The 90-day mortality rates for RARC and ORC were found to be 0% and 7.5%, respectively. There was no difference in pathological outcomes between the two groups. Conclusion: Our initial experience with RARC has demonstrated its safety and practicability, with comparable pathology outcomes, reduction of perioperative blood loss, and advances in 90-day mortality, when compared to ORCs with more years of experience.
Keywords : Komplikasyon, Mesane kanseri, Robot yardımlı radikal sistektomi