Utilization Trends and Short-term Outcomes of Robotic Versus Open Radical Cystectomy for Bladder Cancer

Urology ◽  
2017 ◽  
Vol 103 ◽  
pp. 117-123 ◽  
Author(s):  
Jamie S. Pak ◽  
Jason J. Lee ◽  
Khawaja Bilal ◽  
Mark Finkelstein ◽  
Michael A. Palese
2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Jamie S Pak ◽  
Khawaja Bilal ◽  
Mark Finkelstein ◽  
Michael A Palese

2016 ◽  
Vol 23 (6) ◽  
pp. 598-605 ◽  
Author(s):  
Amy Y. Li ◽  
Christopher P. Filson ◽  
John M. Hollingsworth ◽  
Chang He ◽  
Alon Z. Weizer ◽  
...  

Background. Robotic-assisted radical cystectomy (RARC) is gaining traction as a surgical approach, but there are limited data on patient-reported outcomes for this technique compared to open radical cystectomy (ORC). Objective. To compare health-related quality of life (HRQoL) and short-term convalescence among bladder cancer patients who underwent ORC and RARC. Methods. Review of a single-institution bladder cancer database was conducted. Baseline and postoperative HRQoL was evaluated using the Bladder Cancer Index (BCI) for 324 patients who had ORC (n = 267) or RARC (n = 57) between 2008 and 2012. The BCI assesses function and bother in urinary, bowel, and sexual domains. Among 87 distinct patients (ORC n = 67, RARC n = 20), we also evaluated short-term postoperative convalescence using the Convalescence and Recovery Evaluation (CARE) questionnaire. Our primary outcomes were HRQoL within 12 months and short-term convalescence within 6 weeks following cystectomy. We fit generalized estimating equation regression models to estimate longitudinal changes in BCI scores within domains, and CARE domain score differences were tested with Wilcoxon rank-sum tests. Results. Clinical characteristics and baseline BCI/CARE scores were similar between the 2 groups (all P > .05). Within 1 year after surgery, recovery of HRQoL across all BCI domains was comparable, with scores nearly returning to baseline at 1 year for all patients. CARE scores at 4 weeks revealed that patients treated with ORC had better pain (29.1 vs 20.0, P = .02) domain scores compared to RARC. These differences abated by week 6. Conclusions. HRQoL recovery and short-term convalescence were similar in this cohort following ORC and RARC.


2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Stephen F. Kappa ◽  
Todd M. Morgan ◽  
R. Lawrence Van Horn ◽  
Sam S. Chang ◽  
Peter E. Clark ◽  
...  

Author(s):  
Omar M Aboumarzouk ◽  
Jasper Bondad ◽  
Kamran Ahmed ◽  
Mohammed S Khan ◽  
Howard G Kynaston ◽  
...  

2019 ◽  
Vol 47 (10) ◽  
pp. 4604-4618 ◽  
Author(s):  
Hongbin Shi ◽  
Jiangsong Li ◽  
Kui Li ◽  
Xiaobo Yang ◽  
Zaisheng Zhu ◽  
...  

Background We performed a systematic review and meta-analysis to evaluate the efficacy and safety of minimally invasive radical cystectomy (MIRC) versus open radical cystectomy (ORC) for bladder cancer. Methods We searched the EMBASE and MEDLINE databases to identify randomized controlled trials (RCTs) of MIRC versus ORC in the treatment of bladder cancer. Results Eight articles describing nine RCTs (803 patients) were analyzed. No significant differences were found between MIRC and ORC in two oncologic outcomes: the recurrence rate and mortality. Additionally, no significant differences were found in three pathologic outcomes: lymph node yield, positive lymph nodes, and positive surgical margins. With respect to perioperative outcomes, however, MIRC showed a significantly longer operating time, less estimated blood loss, lower blood transfusion rate, shorter time to regular diet, and shorter length of hospital stay than ORC. The incidence of complications was similar between the two techniques. We found no statistically significant differences in the above outcomes between robot-assisted radical cystectomy and ORC or between laparoscopic radical cystectomy and ORC with the exception of the complication rate. Conclusions MIRC is an effective and safe surgical approach in the treatment of bladder cancer. However, a large-scale multicenter RCT is needed to confirm these findings.


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