We compared the perioperative outcomes of open (ORC) and robot-assisted laparoscopic radical cystectomy (RARC) for patients with bladder cancer. We retrospectively investigated the intraoperative and 90-day postoperative complications of ORC and RARC performed from March 2014 to September 2021 based on the medical records. Perioperative complications were categorized according to the Clavien- Dindo classification. We used the propensity score matching to adjust for the inherent bias of the different patient characteristics at baseline including gender, age, preoperative chemotherapy, and pathological T classification. Surgery time of RARC was significantly shorter than that of ORC, and blood transfusion was significantly less frequent in RARC than in ORC (3% vs 81%, p<0.01). The rate of overall complications of Grade III/IV was lower in RARC (8%) than in ORC (25%) (P=0.09). The prevalence of perioperative urinary tract infection, ileus, and abscess/infectious cyst was similar in ORC and RARC. In patients who underwent RARC, the complication rate was similar in extracorporeal and intracorporeal urinary diversion. Compared to ORC, RARC is more beneficial to reduce blood loss and severe complications.

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http://dx.doi.org/10.14989/ActaUrolJap_68_10_317DOI Listing

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Article Synopsis
  • - The study compared the effectiveness of robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC + ICUD) to open radical cystectomy (ORC) for treating bladder cancer, analyzing data from 316 patients between 2014 and 2023.
  • - Findings showed that RARC + ICUD led to significantly lower risks of complications, blood loss, and hospital stays, and resulted in higher lymph node counts compared to ORC, implying better immediate surgical outcomes.
  • - Despite better perioperative results for RARC + ICUD, the long-term cancer-related outcomes, including survival and recurrence rates, were similar between both surgical approaches.
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Introduction: The aim of this study was to evaluate the differences in perioperative outcomes of cutaneous ureterostomy (CUS) between open surgery (open radical cystectomy, ORC) and robot-assisted surgery (robot-assisted radical cystectomy, RARC), including the stent-free rate, readmission rates due to urinary tract infection (UTI), and changes in renal function.

Methods: Between 2005 and 2023, a total of 37 patients underwent CUS following ORC, while 24 patients underwent CUS following RARC. Perioperative outcomes were compared between these two groups.

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Objectives: To evaluate the safety and effectiveness of robot-assisted radical cystectomy (RARC), laparoscopic radical cystectomy (LRC), and open radical cystectomy (ORC) in bladder cancer.

Methods: A literature search for network meta-analysis was conducted using international databases up to February 29, 2024. Outcomes of interest included baseline characteristics, perioperative outcomes and oncological outcomes.

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Background: The benefits of a robot-assisted radical cystectomy (RARC) compared to an open approach is still under debate. Initial data on RARC were from trials where urinary diversion was performed by an extracorporeal approach, which does not represent a completely minimally invasive procedure. There are now updated data for RARC with intracorporeal urinary diversion that add to the evidence profile of RARC.

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Article Synopsis
  • A systematic review and meta-analysis examined the differences between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) by evaluating data from several randomized controlled trials (RCTs) regarding patient outcomes.
  • The primary focus was on health-related quality of life (QoL) after surgery, with findings showing no significant differences in QoL, complication rates, or oncological outcomes between the two methods at 3 and 6 months post-surgery.
  • RARC had advantages in transfusion rates but required longer operative times and incurred higher costs, making both procedures viable options for treating bladder cancer.
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