Jeremy Yuen Chun TeohErica On Ting ChanSeok Ho KangManish I. PatelSatoru MutoCheng Kuang YangShingo HatakeyamaTimothy Shing Fung ChowAlex MokRuiyun ZhangKittinut KijvikaiLui Shiong LeeHaige ChenChikara OhyamaShigeo HorieEddie Shu Yin ChanRamathibodi HospitalJuntendo University Graduate School of MedicineThe University of Sydney School of MedicineShanghai Jiao Tong University School of MedicineHirosaki UniversityKorea University College of MedicineSingapore General HospitalVeterans General Hospital-Taichung TaiwanWestmead HospitalChinese University of Hong KongEuropean Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working GroupSengkang General Hospital2022-08-042022-08-042021-12-01Annals of Surgical Oncology. Vol.28, No.13 (2021), 9209-921515344681106892652-s2.0-85108639507https://repository.li.mahidol.ac.th/handle/20.500.14594/77569Purpose: 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.Mahidol UniversityMedicineArticleSCOPUS10.1245/s10434-021-10295-5