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Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Correspondence to Jeremy Yuen-Chun Teoh FRCSEd.

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Appendix 1

Appendix 1

See Table

Table 6 RARC case breakdown by place (n = 556)

6.

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Teoh, J.YC., Chan, E.OT., Kang, SH. et al. Perioperative Outcomes of Robot-Assisted Radical Cystectomy with Intracorporeal Versus Extracorporeal Urinary Diversion. Ann Surg Oncol 28, 9209–9215 (2021). https://doi.org/10.1245/s10434-021-10295-5

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  • DOI: https://doi.org/10.1245/s10434-021-10295-5

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