Effect of Robot-Assisted Radical Cystectomy With Intracorporeal Urinary Diversion vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients With Bladder Cancer

Abstract

This is a repository copy of Effect of robot-assisted radical cystectomy with intracorporeal urinary diversion vs open radical cystectomy on 90-day morbidity and mortality among patients with bladder cancer : a randomized clinical trial.

Saudi Urological Association consensus guidelines on the use of robotic surgery in urology

“…Similarly, robotic-assisted adrenalectomy (RAA) is safe and effective for benign adrenal masses, with a wide operative time of 98–234 min, a hospital stay of 1.1–6.4 days, estimated blood loss of 50–576 mL, and laparoscopic or open conversion rates of 0 = 40%. [ 30 32 ] Brunaud and associates reported that RAA was two times more costly than the laparoscopic approach, with a 10% perioperative complication rate,[ 33 ] while Giulianotti et al . reported a 2.4% postoperative complication rate and 2.4% mortality rate.…”

Robotic surgery: getting the evidence right

“…The primary outcome of the iROC trial was that patients treated with intracorporeal RARC had a higher number of days out of hospital within 90 days (82 days v 80 days). Secondary findings suggested a lower risk of thromboembolic complications (2% v 8%) and lower wound complications (6% v 16%) in the RARC treated patients 24 . Patients treated with ORC had poorer quality of life and greater disability at 5 weeks, which was subsequently not significantly different beyond 12 weeks 24 .…”

“…This led to the development of the iROC trial, a multicentre RCT comparing ORC with intracorporeal RARC. This phase 3 trial used a novel primary endpoint of number of days alive and out of hospital within 90 days from surgery, 23 and has recently reported outcomes 24 …”

“…There are now data to support the use of robotic surgery for radical cystectomy 24 . The primary outcome of the iROC trial was that patients treated with intracorporeal RARC had a higher number of days out of hospital within 90 days (82 days v 80 days).…”

Reply by Authors

“…Few multi-institutional randomized controlled trials were able to evaluate the impact of robotics in complex oncologic procedures and have shown excellent perioperative and quality-of-life outcomes. 1,2 We agree that the assessment of robotics in radical nephrectomy with IVC thrombectomy using a randomized controlled trial might be challenging, and hence a well-structured multi-institutional registry with collaborative reporting could be a feasible alternative.…”