You have accessJournal of UrologyTechnology & Instruments: Robotics - Malignant Disease & Benign Disease II1 Apr 20121389 COMPARATIVE EFFECTIVENESS AND COSTS OF ROBOTIC-ASSISTED LAPAROSCOPIC VERSUS OPEN RADICAL CYSTECTOMY Hua-yin Yu, Nathanael Hevelone, Stuart Lipsitz, Keith Kowalczyk, Paul Nguyen, Toni Choueiri, and Jim Hu Hua-yin YuHua-yin Yu Boston, MA More articles by this author , Nathanael HeveloneNathanael Hevelone Boston, MA More articles by this author , Stuart LipsitzStuart Lipsitz Boston, MA More articles by this author , Keith KowalczykKeith Kowalczyk Washington, DC More articles by this author , Paul NguyenPaul Nguyen Boston, MA More articles by this author , Toni ChoueiriToni Choueiri Boston, MA More articles by this author , and Jim HuJim Hu Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1838AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although robotic-assisted laparoscopic radical cystectomy (RARC) has gained popularity, there is a paucity of population-based data comparing it to open radical cystectomy (ORC). We aimed to characterize inpatient utilization, outcomes, and costs of RARC vs. ORC using nationally representative data. METHODS We characterized 2009 RARC vs. ORC utilization and outcomes from the Nationwide Inpatient Sample. Multivariable regressions were used to compare RARC vs. ORC inpatient morbidity, mortality, transfusions, use of parenteral nutrition and lymph node dissection, length of stay, and costs. RESULTS RARC accounted for 13.3% of U.S. radical cystectomies in 2009. RARC vs. ORC was more likely to be performed in teaching hospitals (95.7% vs. 73.1%, p <.01), and patients undergoing RARC were more than twice as likely to undergo lymph node dissection (OR=2.38, 95% CI 1.33, 3.98). RARC was associated with fewer overall complications (OR=0.68, 95% CI .28, .79) and markedly lower mortality (OR=.02, 95% CI .01, .03) compared to ORC (Table). Additionally, RARC was associated with fewer transfusions (OR=0.47, 95%CI .28, .79) and less use of parenteral nutrition (OR=0.47, 95% CI .26, .82). Mean hospital length of stay was 1.9 days shorter for RARC vs. ORC (95%CI -3.1, -.7 days), whereas mean costs were similar between surgical approaches. Limitations include inability to control for tumor characteristics and absence of long-term outcomes. CONCLUSIONS RARC is associated with less inpatient morbidity, mortality, transfusions, and use of parenteral nutrition, shorter length of stay, and greater use of lymph node dissection compared with ORC. Despite higher costs of robotic-assisted laparoscopic surgery, mean costs were similar for ORC vs. RARC. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e564 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hua-yin Yu Boston, MA More articles by this author Nathanael Hevelone Boston, MA More articles by this author Stuart Lipsitz Boston, MA More articles by this author Keith Kowalczyk Washington, DC More articles by this author Paul Nguyen Boston, MA More articles by this author Toni Choueiri Boston, MA More articles by this author Jim Hu Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...