Robot-assisted radical cystectomy. Pilot study for the prospective evaluation of perioperative parameters compared to open radical cystectomy

• Published in: Urologe. Ausgabe A Vol. 50; no. 9; pp. 1076 - 1082
• Main Authors: Niegisch, G, Rabenalt, R, Albers, P
• Format: Journal Article
• Language: German
• Published: Germany 01.09.2011
• Subjects: Aged; Carcinoma, Transitional Cell - surgery; Comorbidity; Convalescence; Cystectomy - methods; Erythrocyte Transfusion; Female; Humans; Length of Stay; Male; Middle Aged; Multicenter Studies as Topic; Pilot Projects; Postoperative Complications - etiology; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies; Robotics - methods; Urinary Bladder Neoplasms - surgery; Urinary Diversion - methods
• ISSN: 1433-0563
• DOI: 10.1007/s00120-011-2580-0

For robot-assisted radical cystectomy prospective assembly and evaluation of peri- and postoperative parameters within a national database is planned. This pilot study evaluated which parameters should be assessed and which problems might occur for assembly and interpretation of data. Of 84 patients with radical cystectomy, 14 underwent RARC. Evaluable patients were compared to patients with open radical cystectomy (ORC) regarding perioperative parameters. In addition, a literature review on published single-center RARC series and comparative investigations (RARC vs ORC) was performed. Published data were compared to results of our own series. RARC patients received less packed red blood cells [RARC: 0 (0-2), ORC 2 (0-12), p=0.009] and hospitalization was shorter [RARC: 14 (8-18) days, ORC: 18 (11-97) days, p=0.015]. Comorbidities as assessed by the Charlson Comorbidity Index were less common in RARC patients [RARC: 4 (3-8), ORC: 6 (3-11), p=0.11]. No major differences between our own and published results were observed. The rate of continent urinary diversions in the Düsseldorf RARC cohort was, apart from one study, larger. Problems in the assembly and interpretation of operation time, blood loss, transfusion rate, and postoperative recovery were observed. Even in this small cohort results of published studies were confirmed. Potential problems in data assembly were identified. Appropriate solutions will be implemented in the national database.