Surgeons Performing More Radical Cystectomies Robotically
Surgeons are performing a growing proportion of radical cystectomies robotically.
SAN DIEGO—Surgeons are performing a growing proportion of radical cystectomies robotically, an approach associated with short-term outcomes similar to those of open surgery, according to a study of New York State data presented at the American Urological Association annual meeting.
From 2009 to 2012, the number of surgeons performing robotic-assisted radical cystectomy (RARC) in the state increased from 56 to 66, whereas the number performing open radical cystectomy (ORC) decreased from 117 to 109, investigators at the Mount Sinai Icahn School of Medicine in New York reported. The proportion of patients undergoing RARC increased from 19.9% to 28.9%, Jamie S. Pak, a fourth-year medical student, and colleagues reported.
Across the study period, the median approach-specific surgeon volume was significantly lower for RARC than ORC (3 vs. 8 cases per year).
Results also showed that the proportion of patients undergoing pelvic lymph node dissection and ileal conduit creation was significantly higher with RARC than ORC (80% vs. 70.4% and 80.5% vs. 76.6%, respectively).
The proportion of patients requiring blood transfusion was significantly lower with RARC than ORC (34.3% vs. 47.4%). In multivariate analysis, RARC was associated with 40% lower odds of blood transfusion compared with ORC.
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Researchers found no significant differences in inpatient complication rate, hospital length of stay, hospital charges at the index stay, readmission rates, or mortality rates during the index stay or at 30 or 90 days.
For the study, the researchers analyzed data from an all-payer statewide reporting system database. The study included 2,525 patients, 610 who underwent RARC and 1,915 who underwent ORC. The cohorts did not differ significantly with respect to age, gender, race, comorbidities, and primary payer.