Predicting perioperative outcomes of robot-assisted radical cystectomy: Data from the Asian Robot-Assisted Radical Cystectomy Consortium
Issued Date
2022-01-01
Resource Type
ISSN
09198172
eISSN
14422042
Scopus ID
2-s2.0-85131329347
Pubmed ID
35613922
Journal Title
International Journal of Urology
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Urology (2022)
Suggested Citation
Lee A.Y., Allen J.C., Teoh J.Y.C., Kang S.H., Patel M.I., Muto S., Yang C.K., Hatakeyama S., Zhang R., Kijvikai K., Chen H., Ohyama C., Horie S., Chan E.S.Y., Lee L.S. Predicting perioperative outcomes of robot-assisted radical cystectomy: Data from the Asian Robot-Assisted Radical Cystectomy Consortium. International Journal of Urology (2022). doi:10.1111/iju.14937 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86531
Title
Predicting perioperative outcomes of robot-assisted radical cystectomy: Data from the Asian Robot-Assisted Radical Cystectomy Consortium
Author's Affiliation
European Association of Urology
Sengkang General Hospital
Ramathibodi Hospital
Juntendo University Graduate School of Medicine
The University of Sydney School of Medicine
Duke-NUS Medical School
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
Sengkang General Hospital
Ramathibodi Hospital
Juntendo University Graduate School of Medicine
The University of Sydney School of Medicine
Duke-NUS Medical School
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
Other Contributor(s)
Abstract
Objectives: To report the perioperative outcomes of robot-assisted radical cystectomy and elucidate their risk factors. Methods: A review of the Asian Robot-Assisted Radical Cystectomy Consortium database from 2007 to 2020 was performed. The perioperative outcomes studied included complication rates, time to solid food intake, estimated blood loss, length of hospital stay, and 30-day readmission rates. Results: Of 568 patients, the overall complication rate was 49.2%, comprising major complications in 15.6%. Preoperative hydronephrosis was associated with an increased risk of major complications (odds ratio 3.27, 95% confidence interval 1.48–7.26, P = 0.004) while neoadjuvant chemotherapy was protective (odds ratio 0.46, 95% confidence interval 0.25–0.84, P = 0.012). The median time to solid food intake was 4 days (interquartile range 3–7) and smoking was a risk factor (odds ratio 4.28, 95% confidence interval 2.36–7.79, P < 0.001) for prolonged time to solid food intake. Median length of hospital stay was 13 days (interquartile range 9–19), and diabetes mellitus (odds ratio 1.66, 95% confidence interval 1.08–2.56, P = 0.021), neoadjuvant chemotherapy (odds ratio 2.21, 95% confidence interval 1.46–3.33, P < 0.001), and orthotopic bladder substitute creation (odds ratio 2.82, 95% confidence interval 1.90–4.18, P < 0.001) were independent risk factors for prolonged length of hospital stay. The 30-day readmission rate was 23.4% and higher in those with bilateral hydronephrosis (odds ratio 4.58, 95% confidence interval 1.97–10.65, P < 0.001) and orthotopic bladder substitute creation (odds ratio 1.87, 95% confidence interval 1.16–3.02, P = 0.010). Conclusions: There are preoperative conditions which are significant risk factors for adverse perioperative outcomes in robot-assisted radical cystectomy. Most are potentially modifiable and can direct strategies to reduce surgical morbidity related to this major oncological procedure.