STOCKHOLM, SWEDEN (UroToday.com) - This abstract was presented by Dr. Idir Ouzaid from Glickman Urological and Kidney Institute, Cleveland. The objective of this presentation was to compare perioperative and short-term outcomes of patients undergoing extracorporeal robotic assisted laparoscopic radical cystectomy (ecRARC) and intracorporeal robotic assisted laparoscopic radical cystectomy (icRARC) in a propensity matched fashion. Outcomes on 125 patients who underwent RARC and urinary diversion (UD) were presented. Of these, 45 and 80 patients underwent icRARC and ECRARC, respectively. Propensity-score matching was performed in a 1:1 ratio using disease characteristics (TURBT pathology and neoadjuvant chemotherapy), baseline demographics (age, gender, BMI, Charlson comorbidity score, history of smoking, and history of abdominal surgeries), and type of ileal UD (conduit and neobladders). Matched patients were compared with respect to their operative time, estimated blood loss (EBL), length of stay (LOS), time to oral diet, and 90-days complications. Ninety-days readmission and secondary procedure rates were also compared between the two cohorts.
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The group reported that patients who received icRARC had significantly lower EBL compared to the ecRARC group (p = 0.005) and the rate of transfusion was lower (22% vs. 42%, p = 0.07). Operative time, LOS, time to oral intake, as well as complication rates were reported similarly between the two cohorts.
In summary, robotic assisted laparoscopic radical cystectomy is gaining in popularity as an alternative to the open approach. Authors demonstrated that icRARC has the potential benefit of decreased estimated blood loss over ecRARC without additional morbidity and surgery time. Reported results should be further validated by other centers and larger cohorts.
Presented by Idir Ouzaid at the 29th Annual European Association of Urology (EAU) Congress - April 11 - 15, 2014 - Stockholmsmässan - Stockholm, Sweden.
Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland USA
Written by Reza Mehrazin, MD, medical writer for UroToday.com