You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2015MP67-17 PERIOPERATIVE CHARACTERISTICS OF ROBOTIC VERSUS OPEN CYSTECTOMY IN THE ELDERLY POPULATION Brian Winters, Prashoban Bremjit, Bruce Dalkin, Daniel Lin, William Ellis, John Gore, Michael Porter, Jonathan Harper, and Jonathan Wright Brian WintersBrian Winters More articles by this author , Prashoban BremjitPrashoban Bremjit More articles by this author , Bruce DalkinBruce Dalkin More articles by this author , Daniel LinDaniel Lin More articles by this author , William EllisWilliam Ellis More articles by this author , John GoreJohn Gore More articles by this author , Michael PorterMichael Porter More articles by this author , Jonathan HarperJonathan Harper More articles by this author , and Jonathan WrightJonathan Wright More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2500AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment for muscle invasive bladder cancer (MIBC) remains highly morbid despite improving surgical techniques. As the median age of diagnosis is ∼73, many patients are elderly at the time of cystectomy consideration. We attempt to compare perioperative surgical outcomes in robotic vs. open approaches in elderly patients undergoing cystectomy for MIBC. METHODS An IRB approved, retrospective chart review was performed examining all patients undergoing radical cystectomy for MIBC between 10/2003 and 4/2014. Analysis was limited to those patients aged greater than 75 at time of surgery. Demographic (age, race, gender), clinical (date of diagnosis, histology, stage, previous treatments (BCG/Radiation/Chemotherapy), comorbidities, serum creatinine), pathologic (stage, nodal status, surgical margin, presence of lymphovascular invasion), and perioperative (EBL, ICU stay, hospital course, discharge disposition, surgical complications, readmission within 90 days) variables were examined. RESULTS 72 patients >75 years of age underwent cystectomy for MIBC (57 open, 15 robotic). Mean age was 79.6 (+/-3.2) and 79.3 (+/-3.6) for open and robotic groups, respectively (p=0.78). There were no significant differences in baseline comorbidities, clinical or pathologic stage, or use of neoadjuvant chemotherapy (all p>0.20). Mean number of lymph nodes removed was similar (open: 14.2 (+/-9.8), robotic: 12.9 (+/-6.7), p=0.63). Median blood loss was less with robotic (300cc (IQR 150-500)) compared to open (700cc (IQR 400-1000) surgeries (median test, p=0.018), although on multivariate analysis robotic surgery was not significantly associated with EBL (327 less cc for robotic surgery, p=0.11). RBC transfusions were given to 18 (35%) and 1 (7%) of the open and robotic patients, respectively (p < 0.05). There was no difference in need for postoperative ICU stay (p=0.51) but median hospital stay was longer for open (8 days (IQR 6-22)) vs. robotic (7 days (IQR 6-7) patients (p=0.002). Length of stay > 1 week was seen in 67% and 7% of open and robotic cases, respectively. There were no significant differences in surgical complications or 90-day readmission rates (21% vs. 20%, p=0.38). CONCLUSIONS Robotic cystectomy is safe and feasible in an elderly population. In our cohort, we observed fewer blood transfusions and shorter hospital stays with robotic cystectomy compared to the open surgery, however, radical cystectomy remains a morbid operation regardless of surgical approach. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e856 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Winters More articles by this author Prashoban Bremjit More articles by this author Bruce Dalkin More articles by this author Daniel Lin More articles by this author William Ellis More articles by this author John Gore More articles by this author Michael Porter More articles by this author Jonathan Harper More articles by this author Jonathan Wright More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...