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Robotic vs. Open Radical Cystectomy: Identification of Patients who Benefit from the Robotic Approach.
MedLine Citation:
PMID:  22788707     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose: To identify patients who would benefit from robotic assisted radical cystectomy (RARC). We report perioperative outcomes and complications. Materials and Methods: Compared the patients who underwent RARC to patients who OC in our institution. Data included demographics, operative variables, and recovery. Complications were grouped into: early (<30 days), intermediate (31-90 days), and late (>30 days). Results: There were 58 patients in RARC group and 84 patients in the OC group. The mean age was 66 ± 1.2 years in the RARC vs 67 ± 1.2 in OC (p=0.53). Females constituted of 21% in RARC and 30% in OC (p=0.23). The mean ASA scores were 2.9 for RARC and 2.94 for OC (p=0.5). The mean operative time for RARC was 7.8 ± 1.5 hours vs 6.6 ± 1.25 hours for OC (p<0.0001). However, estimated blood loss was 276 ± 48 cc in RARC vs 1522 ± 369 cc in OC (p <0.0001). Positive margins rate was 7% in RARC vs 8% in OC (p=0.8). Early complications of any severity (Clavien Scores) occurred in 43% in RARC and 64% (p=0.02). There was one mortality in RARC versus two mortalities in OC. Patients were grouped by age (≥ 70 and <70 years old). The older group consisted of 19 and 44 patients in RARC and OC respectively. Both age groups in RARC had less early complications than OC patients (p<0.014). In fact, the older group in RARC had less early complication rate (17%) than the younger group in OC (59%). Conclusions: RARC has improved perioperative outcomes and equivalent oncological parameters when compared to open cystectomy. Patients ≥70 years old particularly benefit from the robotic approach particularly when compared to younger patients undergoing open cystectomy.
Authors:
Michael Landers Knox; Rizk El-Galley; J Erik Busby
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-12
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
UAB, Surgery, Division of Urology, 1105 FOT, 1530 3rd Ave. S, Birmingham, Alabama, United States, 35294, 205 934 1461; michael.knox@ccc.uab.edu.
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