Publication: Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion
Issued Date
2021-12-01
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ISSN
15344681
10689265
10689265
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2-s2.0-85108639507
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Mahidol University
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SCOPUS
Bibliographic Citation
Annals of Surgical Oncology. Vol.28, No.13 (2021), 9209-9215
Suggested Citation
Jeremy Yuen Chun Teoh, Erica On Ting Chan, Seok Ho Kang, Manish I. Patel, Satoru Muto, Cheng Kuang Yang, Shingo Hatakeyama, Timothy Shing Fung Chow, Alex Mok, Ruiyun Zhang, Kittinut Kijvikai, Lui Shiong Lee, Haige Chen, Chikara Ohyama, Shigeo Horie, Eddie Shu Yin Chan Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion. Annals of Surgical Oncology. Vol.28, No.13 (2021), 9209-9215. doi:10.1245/s10434-021-10295-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77569
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Title
Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion
Other Contributor(s)
Ramathibodi Hospital
Juntendo University Graduate School of Medicine
The University of Sydney School of Medicine
Shanghai Jiao Tong University School of Medicine
Hirosaki University
Korea University College of Medicine
Singapore General Hospital
Veterans General Hospital-Taichung Taiwan
Westmead Hospital
Chinese University of Hong Kong
European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group
Sengkang General Hospital
Juntendo University Graduate School of Medicine
The University of Sydney School of Medicine
Shanghai Jiao Tong University School of Medicine
Hirosaki University
Korea University College of Medicine
Singapore General Hospital
Veterans General Hospital-Taichung Taiwan
Westmead Hospital
Chinese University of Hong Kong
European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group
Sengkang General Hospital
Abstract
Purpose: This study was designed to investigate and compare the perioperative outcomes of intracorporeal urinary diversion (ICUD) versus extracorporeal urinary diversion (ECUD) following robotic-assisted radical cystectomy (RARC) in patients with localized bladder cancer from the Asian Robot-Assisted Radical Cystectomy (RARC) Consortium. Methods: The Asian RARC registry was a multicenter registry involving nine centers in Asia. Consecutive patients who underwent RARC were included. Patient and disease characteristics, intraoperative details, and perioperative outcomes were reviewed and compared between the ICUD and ECUD groups. Postoperative complications were the primary outcomes, whereas secondary outcomes were the estimated blood loss and the duration of hospitalization. Multivariate regression analyses were performed to adjust potential confounders. Results: From 2007 to 2020, 556 patients underwent RARC; 55.2% and 44.8% had ICUD and ECUD, respectively. ICUD group had less estimated blood loss (423.1 ± 361.1 vs. 541.3 ± 474.3 mL, p = 0.002) and a shorter hospital stay (15.7 ± 12.3 vs 17.8 ± 11.6 days, p = 0.042) than the ECUD group. Overall complication rates were similar between the two groups. Upon multivariate analysis, ICUD was associated with less estimated blood loss (Regression coefficient: − 143.06, 95% confidence interval [CI]: − 229.60 to − 56.52, p = 0.001) and a shorter hospital stay (Regression coefficient: − 2.37, 95% CI: − 4.69 to − 0.05, p = 0.046). In addition, ICUD was not associated with any increased risks of minor, major, and overall complications. Conclusions: RARC with ICUD was safe and technically feasible with similar postoperative complication rates as ECUD, with additional benefits of reduced blood loss and a shorter hospitalization.