A Single-centre Early Phase Randomised Controlled Three-arm Trial of Open, Robotic, and Laparoscopic Radical Cystectomy (CORAL)

Khan, Muhammad Shamim; Gan, Christine; Ahmed, Kamran; Ismail, Ahmad Fahim; Watkins, Jane; Summers, Jennifer; Peacock, Janet L.; Rimington, Peter; Dasgupta, Prokar

doi:10.1016/j.eururo.2015.07.038

Cited by 269 publications

(274 citation statements)

References 29 publications

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“…In our series, patients undergoing RARC and intra-corporeal urinary diversion experienced a mean overall blood loss of 534 ± 153.2 ml. This finding is comparable to other previously reported prospective, randomized and retrospective studies [5,15,16], with median blood loss ranging 208-1,118 ml, depending on the type (ileal conduit, neobladder) and surgical approach adopted (ex-tracorporeal, intracorporeal) for urinary diversion [17]. It is important to underline the low need for intra-operative transfusions (5.9%) in our series, which is remarkably lower if compared to other RARC series, ranging 7-44% [17].…”

Section: Discussionsupporting

confidence: 82%

“…This result is comparable with most of the studies that have been published to date [8,15,16,18]. The most complex surgical steps during RARC, especially considering the reconstructive phases (intracorporeal urinary diversion, ileal neoblad-der), actually represent the most important factors responsible for a longer operative time.…”

Section: Discussionsupporting

confidence: 78%

“…Furthermore, the rate of intraoperative transfusions was found to be lower in the RARC group (5.9 vs. 24.2%). These findings are not surprising, since many reports and systematic reviews of cumulative or randomized studies confirmed the advantage of robotic approach in decreasing the blood loss and transfusions rate when compared to open technique [5,7,15,16,18,19]. …”

Section: Discussionmentioning

confidence: 94%

“…If compared to these data, in our series we observed a quite lower mean blood loss (777 ml) and transfusions rate (24%) in ORC patients. Interestingly, 2 recent randomized trials with a larger cohort of patients [15,16] and 2 systematic review and meta-analyses [5,17] reported comparable blood loss and transfusions rates. In our series, patients undergoing RARC and intra-corporeal urinary diversion experienced a mean overall blood loss of 534 ± 153.2 ml.…”

Section: Discussionmentioning

confidence: 99%

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Peri-Operative Outcomes after Open and Robot-Assisted Radical Cystectomy by Using an Advanced Bipolar Seal and Cut Technology (Caiman®): A Prospective, Comparative, and Multi-Institutional Study

et al. 2019

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Objective: To report and compare the peri-operative outcomes of patients undergoing open (ORC) and robotic-assisted radical cystectomy (RARC) for bladder cancer performed with a radiofrequency seal and cut device (Caiman®). Materials and Methods: Data of patients undergoing ORC or RARC between January 2015 and March 2016 at 6 Italian institutions were prospectively recorded and analyzed. Thirty-and 90-day complications were stratified according to the Martin's criteria and graded according to the Clavien-Dindo classification. Data on operative time, blood loss, transfusion rate, complications, and length of stay were evaluated and compared between the ORC and RARC groups. Results:Thirty-three (66%) and 17 (34%) patients were treated with ORC and RARC, respectively. The median age was 72 (64-78) years. Overall operative time was longer in RARC compared to ORC (389 ± 80.1 vs. 242 ± 62.2 min, p < 0.001), while the estimated blood loss during cystectomy was higher after ORC (370 ± 126.8 vs. 243.3 ± 201.6 ml, p = 0.03). The transfusion rate was significantly higher in the ORC compared to RARC (24.2 vs. 5.9%, p = 0.04). Eight (19%) and 7 (16.7%) patients experienced 30- and 90-day post-operative complications, with no significant difference between ORC and RARC. Length of stay was significantly shorter in RARC group (median 7 vs. 14 days, p < 0.001). Conclusion: Open and robot-assisted procedures were safely performed by using a new advanced bipolar seal and cut technology (Caiman®). RARC demonstrated to be superior to ORC in terms of bleeding, transfusion rates and length of hospital stay, despite longer operative time.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Peri-Operative Outcomes after Open and Robot-Assisted Radical Cystectomy by Using an Advanced Bipolar Seal and Cut Technology (Caiman®): A Prospective, Comparative, and Multi-Institutional Study

et al. 2019

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“…194,195 No significant difference was found between groups with respect to postoperative complications or duration of hospital stay. At the time of publication, there were no oncologic or functional outcomes yet available.…”

Section: Discussionmentioning

confidence: 69%

Recommendations for the improvement of bladder cancer quality of care in Canada: A consensus document reviewed and endorsed by Bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015

Kassouf

Aprikian

Black

et al. 2016

CUAJ

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This initiative was undertaken in response to concerns regarding the variation in management and in outcomes of patients with bladder cancer throughout centres and geographical areas in Canada. Population-based data have also revealed that real-life survival is lower than expected based on data from clinical trials and/or academic centres. To address these perceived shortcomings and attempt to streamline and unify treatment approaches to bladder cancer in Canada, a multidisciplinary panel of expert clinicians was convened last fall for a two-day working group consensus meeting. The panelists included urologic oncologists, medical oncologists, radiation oncologists, patient representatives, a genitourinary pathologist, and an enterostomal therapy nurse. The following recommendations and summaries of supporting evidence represent the results of the presentations, debates, and discussions. Methodology

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Association of Open vs Robot-Assisted Radical Cystectomy With Mortality and Perioperative Outcomes Among Patients With Bladder Cancer in Sweden

et al. 2022

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A Single-centre Early Phase Randomised Controlled Three-arm Trial of Open, Robotic, and Laparoscopic Radical Cystectomy (CORAL)

Cited by 269 publications

References 29 publications

Peri-Operative Outcomes after Open and Robot-Assisted Radical Cystectomy by Using an Advanced Bipolar Seal and Cut Technology (Caiman®): A Prospective, Comparative, and Multi-Institutional Study

Peri-Operative Outcomes after Open and Robot-Assisted Radical Cystectomy by Using an Advanced Bipolar Seal and Cut Technology (Caiman®): A Prospective, Comparative, and Multi-Institutional Study

Recommendations for the improvement of bladder cancer quality of care in Canada: A consensus document reviewed and endorsed by Bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015

Association of Open vs Robot-Assisted Radical Cystectomy With Mortality and Perioperative Outcomes Among Patients With Bladder Cancer in Sweden

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