AI Article Synopsis
- Robotic-assisted cystectomy using intracorporeal urinary diversion (ICUD) shows promising outcomes compared to extracorporeal urinary diversion (ECUD), leading to shorter hospital stays and fewer intraoperative transfusions.
- A study of 174 patients revealed that while operative times were similar, ICUD patients had significantly better results in terms of recovery times and lower complication rates linked to specific risk factors.
- The findings suggest that ICUD may be a more advantageous choice for certain patients considering robotic-assisted cystectomy, informing clinical practices in surgical decision-making.
Article Abstract
Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches.
Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed.
Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate.
Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953604 | PMC |
| http://dx.doi.org/10.1590/S1677-5538.IBJU.2023.0477 | DOI Listing |
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