Does the presence of significant risk factors affect perioperative outcomes after robot‐assisted radical cystectomy?

Abstract

OBJECTIVE To evaluate the effect of preoperative risk factors on perioperative outcomes up to 3 months after robot‐assisted radical cystectomy (RARC), as RC continues to be associated with a high rate of morbidity and mortality. PATIENTS AND METHODS From 2005 to 2007, 66 consecutive patients had RARC at Roswell Park Cancer Institute. Patient demographics, preoperative risk factors and complications up to 3 months after RARC were reviewed from a prospective quality‐assurance database. Patients were stratified into high‐ and low risk groups based on age, previous abdominal surgery, chronic obstructive pulmonary disease (COPD), body mass index (BMI), Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiologists (ASA) score. RESULTS Age, previous abdominal surgery, COPD, BMI, RCRI score and ASA score did not significantly influence complications during or up to 3 months following RARC (P > 0.05). Advanced age was associated with a higher RCRI score (P = 0.014) and an increased likelihood of admission to the Intensive Care Unit (P = 0.007). A higher ASA score was associated with an increased overall hospital stay (P = 0.039). Previous abdominal surgery was associated with more frequent unscheduled postoperative clinic visits (P = 0.014). Operative duration did not significantly influence complication rates (P > 0.05). Fifteen of 62 patients (24%) had a major complication, while 15 (24%) had minor complications within 3 months of surgery. The reoperation rate was 11% and the overall mortality rate was 1.6%. CONCLUSIONS RARC appears to be well tolerated, independent of comorbid risk factors such as age, BMI, RCRI and ASA score.

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

“…Complications associated with RARC and risk factors for complications have been discussed in case series. 19,26,[34][35][36][37][38][39] Johar et al analyzed the data obtained from the IRCC database of 939 patients treated with RARC. 40 The mean EBL was 580 mL; the mean hospital stay was 11 days; the admission rate within 30 or 90 days was 13% or 20%, respectively; and the mortality within 30 and 90 days was 1.3% and 4.2%, respectively.…”

“…Complications associated with RARC and risk factors for complications have been discussed in case series . Johar et al .…”

Robot-Assisted Radical Cystectomy as a Treatment Modality for Patients with Muscle-Invasive Bladder Cancer

“…Different parameters may affect outcome and risk for surgery-related complications such as age, higher ASA score or previous surgery. Butt et al did not find a significant association between age, BMI, ASA score and complication rate in their series of 66 RARC cases 44 .…”

Getting out of a tight spot: an overview of ureteroenteric anastomotic strictures

“…Stricture rates following robot-assisted radical cystectomy range from 1.5% to 17.6%, and are comparable to rates observed following open procedures, although studies have been limited by small patient numbers [40][41][42][43][44][45][46] . In their series of 468 patients at median follow-up of 8.2 months, Andersen et al found no significant difference in stricture rate between the open and robot-assisted groups 1 .…”