Minimally invasive cystectomy is being increasingly performed however, data comparing laparoscopic radical cystectomy (LRC) and robotic radical cystectomy (RRC) is scarce. We compared 30-day and 90-day Clavien-Dindo Classification(CDC) complications between patients undergoing LRC and RRC at our centre.
We retrospectively evaluated 300 patients who underwent minimally invasive radical cystectomy from January 2007 to July 2019 and grouped them into LRC (112 patients) and RRC (188 patients). We compared the 2 groups for demographic variables, peri-operative characteristics and 30-day and 90-day CDC overall, minor and major complications. Multivariable logistic regression analysis was performed to identify variables which predict peri-operative complications.
The 2 groups were comparable for the duration of surgery (270 min in LRC vs 265 min in RRC) and rate of conversion to open surgery. The RRC cohort had a higher estimated blood loss (675 ml vs 500 ml, p=0=0.006), but the two groups had a comparable need for intra-operative transfusion. Patients undergoing RRC also had a shorter duration of hospital stay (13 vs 14 days, p<0.001). There was no difference between the 2 groups for 30-day and 90-day CDC overall, minor and major complications. The incidence of re-hospitalization within 30 days (p=0.1) and surgical re-intervention (p=0.5) was also comparable between the 2 groups. On multivariable logistic regression analysis, approach to cystectomy (RRC vs LRC) was not a significant predictor of 30-day CDC overall and major complications.
LRC was associated with lesser EBL while the hospital stay was shorter in patients undergoing RRC. The two approaches were comparable to each other for 30-day and 90-day CDC overall, minor and major complications. The choice between the 2 approaches should depend on availability and surgeon experience and preference, rather than any specific peri-operative parameter.
Journal of endourology. 2020 Jun 27 [Epub ahead of print]
Amandeep Arora, Felipe Guimarães Pugliesi, Ahmed Salah Zugail, Marco Moschini, Cristiano Linck Pazeto, Petr Macek, Armando Stabile, Camille Lanz, Annick Mombet, Mostefa Bennamoun, Rafael Sanchez-Salas, Xavier Cathelineau
Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, France; ., Institut Mutualiste Montsouris, 26953, Medical Oncology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; ., Institut Mutualiste Montsouris, 26953, Urology, Paris, Île-de-France, France; .