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

Niegisch, Günter; Albers, Peter; Robert, René

doi:10.1016/j.urolonc.2014.03.023

Cited by 37 publications

(26 citation statements)

References 31 publications

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“…Further, whether RARC adds advantages regarding other factors, for example, perioperative systemic inflammatory response is currently under investigation [7]. As far as oncological endpoints are concerned, RARC is reported to provide non-inferior positive surgical margin rate and lymph node yield [4,3]. Further, similar oncological survival outcomes have been reported in two randomized controlled trials, the RAZOR trial and the MSKCC trial [8,9].…”

Section: Introductionmentioning

confidence: 91%

“…ORC including lymphadenectomy and urinary diversion (orthotopic neobladder, ileal conduit, and ureterocutaneostomy) was performed by 4 urologists, as previously described [3].…”

Section: Surgical Techniquementioning

confidence: 99%

“…RARC and lymphadenectomy were performed referring to the original technique of Menon et al [16] and the standardization established by Wang et al [17] as reported before [3,6]. In brief, we used 4 access ports (camera: 3-5 cm supraumbilical, 2 robotic arms 1 palm lateral of the umbilicus, and 1 robotic arm mediocranial of the left anterior superior iliac spine) for the DaVinci ® Si -system and 2 additional ports (laterocranial and lateral of the umbilicus at the right side) for the surgical assistant.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Although it has been questioned that RARC series have stage selection biases [1], a minimally invasive approach provides shorter hospital stay, less blood loss [3], similar 90 days complication rate, but longer operative time and major costs compared to ORC [3][4][5][6]. Further, whether RARC adds advantages regarding other factors, for example, perioperative systemic inflammatory response is currently under investigation [7].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of 2-Year Oncological Outcome and Early Recurrence Patterns in Patients with Urothelial Bladder Carcinoma Treated with Open or Robot-Assisted Radical Cystectomy with an Extracorporeal Urinary Diversion

et al. 2018

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Background: Data on oncological follow-up after robotic-assisted radical cystectomy (RARC) have been reported only scarcely and individual studies have reported an increase in early recurrences and atypical recurrences. Patients and Methods: Clinical data of 89 patients with RARC were compared to 59 patients with open radical cystectomy (ORC) at a single institution. Two-year cancer-specific (2y-CSS) and 2-year overall survival (2y-OS) related to histopathological tumor stage of RARC patients calculated by Kaplan-Meier method were compared to ORC patients using log-rank test. Early clinical recurrence rate (eCR, progression ≤6 months post-cystectomy) and metastatic pattern of both groups were compared by chi-square test. Results: Median follow-up 32 months (RARC) and 47.5 months (ORC), both groups were balanced in baseline characteristics. For RARC pts, 2y-OS and CSS-free survival rates were 80 and 90%, for ORC pts 65 and 71% (all p > 0.05). Margin status was not significantly different. eCR was observed in 10 out of 89 (11%) RARC pts and in 7 out of 59 (12%) ORC pts (p = 0.9). No difference in atypical metastases was seen between groups. Conclusion: Two-year oncological outcomes of RARC patients are comparable to ORC patients without differences regarding ePR or metastatic pattern.

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Section: Introductionmentioning

confidence: 91%

“…ORC including lymphadenectomy and urinary diversion (orthotopic neobladder, ileal conduit, and ureterocutaneostomy) was performed by 4 urologists, as previously described [3].…”

Section: Surgical Techniquementioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of 2-Year Oncological Outcome and Early Recurrence Patterns in Patients with Urothelial Bladder Carcinoma Treated with Open or Robot-Assisted Radical Cystectomy with an Extracorporeal Urinary Diversion

et al. 2018

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“…The comparison between open versus robotic cystectomy has been investigated in multiple studies. Niegisch et al [16] assessed the surgical and oncological outcome of robot assisted radical cystectomy (RARC) of 64 patients who underwent the procedure prospectively and a retrospective comparison with 79 patients who underwent open radical cystectomy (ORC). RARC provided significant advantages compared with ORC regarding blood loss and postoperative recovery, whereas surgical and oncological outcomes were not different [16].…”

Section: Introductionmentioning

confidence: 99%

Robotic Cystectomy

Mahdy¹

2015

UNOAJ

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Comparison of perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy

Zhang

Lin

Zhang

et al. 2020

Robotics Computer Surgery

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Objective To report perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy. Patients and Methods Between January 2010 and July 2019, 298 patients with bladder cancer underwent robotic‐assisted radical cystectomy (RARC) (n = 172) and laparoscopic radical cystectomy (LRC) (n = 126) at our institution were enrolled in the retrospective study. The demographic, perioperative, and complication data were collected and analyzed. Results The RARC group had less operative duration (P < .001), less blood loss (P < .001), lower transfusion rate (P < .05), and shorter hospital stay (P < .001) than the LRC group. The 90‐day readmission rate between the RARC and LRC group had no significant differences (P = .401). The 90‐day overall complication rates in the RARC group was much lower than the LRC group (P = .009). The 90‐day minor complication rates (Clavien‐Dindo grade ≤ IIA) between the RARC and LRC groups were similar (P = .274). The 90‐day major complication rates (Clavien‐Dindo grade ≥ IIIA) in the LRC group was higher than the RARC group (P = .022). Conclusions The RARC approach appears to offer some operative and perioperative benefits compared with the LRC approach. Larger, randomized studies are required to confirm these findings.

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

Cited by 37 publications

References 31 publications

Comparison of 2-Year Oncological Outcome and Early Recurrence Patterns in Patients with Urothelial Bladder Carcinoma Treated with Open or Robot-Assisted Radical Cystectomy with an Extracorporeal Urinary Diversion

Comparison of 2-Year Oncological Outcome and Early Recurrence Patterns in Patients with Urothelial Bladder Carcinoma Treated with Open or Robot-Assisted Radical Cystectomy with an Extracorporeal Urinary Diversion

Robotic Cystectomy

Comparison of perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy

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