Do patients benefit from total intracorporeal robotic radical cystectomy?: A comparative analysis with extracorporeal robotic radical cystectomy from a Korean multicenter study

• Published in: Investigative and clinical urology 2020, 61(1), , pp.11-18
• Main Authors: Shim, Ji Sung, Kwon, Tae Gyun, Rha, Koon Ho, Lee, Young Goo, Lee, Ji Youl, Jeong, Byong Chang, Pyun, Jong Hyun, Kang, Sung Gu, Kang, Seok Ho
• Format: Article
• Language: English
• Subjects: Cohort Studies; Comparative Effectiveness Research; cystectomy; Cystectomy - adverse effects; Cystectomy - methods; Cystectomy - statistics & numerical data; Female; Humans; Length of Stay - statistics & numerical data; Male; Margins of Excision; Middle Aged; Operative Time; Original; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; recurrence; Republic of Korea - epidemiology; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - methods; Robotic Surgical Procedures - statistics & numerical data; robotics; Survival Analysis; Urinary Bladder - pathology; Urinary Bladder - surgery; urinary bladder neoplasms; Urinary Bladder Neoplasms - epidemiology; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; urinary diversion; 비뇨기과학
• ISSN: 2466-0493; 2466-054X
• DOI: 10.4111/icu.2020.61.1.11

This study aimed to compare complications, perioperative parameters, and oncologic outcomes between robot-assisted radical cystectomy (RARC) with extracorporeal urinary diversion (ECUD) and RARC with intracorporeal urinary diversion (ICUD). Between 2007 and 2017, 362 patients who underwent RARC with ECUD or ICUD at multiple tertiary referral institutions were assessed. The primary endpoints were complication rates. The secondary outcomes were perioperative recovery parameters and oncological outcomes including estimated recurrence-free survival (RFS) and recurrence pattern between the 2 groups. Additionally, the complication rates of 2 expert surgeons with experience of >100 RARCs were analyzed. The ICUD group showed lower overall, gastrointestinal, and genitourinary complications (p=0.001, p=0.036, and p=0.036, respectively) than the ECUD group. Concerning perioperative outcomes, the ICUD group had a significantly longer operation time (p=0.002), although recovery parameters such as time to flatus passage, oral intake, and length of hospital stay were significantly shorter in this group (p=0.001, p