Matched Comparison of Robotic-assisted and Open Radical Cystectomy

Perioperative complications and oncological safety of robot-assisted (RARC) vs. open radical cystectomy (ORC)

“…This is in accordance with the recent data of the MSKCC trial presented at 2013 American Urological Association, annual meeting by Laudone et al and further studies as detailed in Table 6 [12][13][14][15]. A lower complication rate following RARC as indicated by the studies of Ng et al [14] and Kader et al [16], as well as by a recent systematic review, was not observed in our analysis [20].…”

“…In contrast to ORC, these questions have been addressed only in several single-center series and 1 multi-institutional database [8][9][10][11]. A direct comparison of ORC and RARC has been performed up to date in 2 small randomized controlled trials (RCTs) ( patients) and some nonrandomized cohort studies [12][13][14][15][16]. Lately, data of the first randomized trial of ORC vs. RARC with 4100 patients has been released (V.P.…”

Controversies in Robotics: Open Versus Robotic Radical Cystectomy

“…Styn et al reported a 28% readmission rate for patients who received RARC compared with 20% for those who received ORC (P ¼ .25). 8 Similarly, Ng et al did not find a significant difference in readmission rates between their robotic and open cohort. 9 In addition to no significant difference in readmission rates, studies have also found no significant difference in complication rates between the 2 modalities.…”

“…7 As shown in Table 1, mean surgical time has been shown to be longer in RARC compared with ORC. 3,[7][8][9][10] During any surgical procedure, especially major surgical endeavors, minimization of blood loss is of paramount import. Wang et al showed a significant reduction in blood loss in RARC compared with ORC (400 mL compared with 750 mL; P ¼ .002) and a lower transfusion requirement (0.5 units compared with 2 units; P ¼ .007).…”

Effect of Intraoperative Red Blood Cell Transfusion on Postoperative Complications After Open Radical Cystectomy: Old Versus Fresh Stored Blood

“…This rate was comparable to that shown in previous studies, in which the incidence of postoperative complications after open radical cystectomy was 34% to 93%. 11,14,[16][17][18][19] Similarly, we showed that postoperative infection was the most common complication, followed by proceduralrelated, gastrointestinal, renal, and vascular complications. 14, [16][17][18][19][20] Numerous factors, including female sex, 14,21 increased age, 11,12 high ASA PS class, 11,12,14,22 prior abdominal or pelvic surgery, 13 preoperative acute renal failure, 13 general anesthesia, 13 operating time, 12 type of urinary diversion, 12,14 previous irradiation for localized prostatic cancer, 23 preoperative anemia, 12 perioperative transfusion, 10-13 low preoperative albumin level, 13 and increased body mass index 21 have been identified as risk factors for postoperative complications after radical cystectomy.…”