Comparison of early stage complications between robotic-assisted radical cystectomy and open radical cystectomy

Abstract

Objective To compare the incidence and characteristics of early stage complications between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC). Methods From December 2013 to September 2015, the demographic and perioperative data of l13 (98 males and 15 females) and 35 (30 males and 5 females) patients who had undergone ORC or RARC respectively were retrospectively analyzed. The average age of patients was (67.2±9.9) and (64.5±8.5) years old in ORC and RARC group, respectively. We reviewed operation time, estimated blood loss, number of dissected lymph node, transfusion rate, time to resumption of oral intake, postoperative drainage length, time to mobility after surgery and complication rate within 90 days after cystectomy. Results Mean operative time was significantly shorter in ORC group than in RARC group [(315±102) min vs. (450±87) min, P 0.05). The complication rate between the two groups was (38.1% vs. 25.7%, P=0.226). The complication above Clavien I was significantly more in ORC group (20 vs. 1, P=0.048). The common complications following ORC were intestinal obstruction(n=19), infection (n=14) , death(n=1), leakage of urine(n=2) and lymphatic leakage(n=18), while in RARC group those were intestinal obstruction(n=4) and lymphatic leakage(n=5). The incidence of infection was significantly more in the ORC group than RARC group (0 vs. 20 patients, P=0.042). Conclusion Patients can benefit more from RARC than ORC, as RARC can reduce estimated blood loss as well as complications. Key words: Bladder cancer; Radical cystectomy; Complications; Robotic-assisted