Prospective Randomized Controlled Trial of Robotic versus Open Radical Cystectomy for Bladder Cancer: Perioperative and Pathologic Results

Nix, Jeff; Smith, Angela M.; Kurpad, Raj; Nielsen, Matthew E.; Wallen, Eric; Pruthi, Raj S.

doi:10.1016/j.eururo.2009.10.024

Cited by 488 publications

(425 citation statements)

References 22 publications

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“…Nix et al reported no difference in complications between the two small groups (n020) within this trial. However, complication rates were not the primary outcome measure in this study and the numbers were underpowered to clearly define this relationship [21].…”

Section: Postoperative Complicationsmentioning

confidence: 95%

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Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Rao

Stegemann

Rehman

et al. 2012

Indian J Surg Oncol

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Robot-assisted radical cystectomy (RARC) for bladder cancer is increasingly becoming popular in specialist centres around the world. RARC has the advantage of being minimally invasive and also the dexterity of the instruments allow reconstruction such as ileal conduit urinary diversion or neobladder formation. Starting from the initial series demonstrating the feasibility of RARC and extended pelvic lymph node dissection, we now have mature series demonstrating equal oncological and functional outcomes in the medium term follow-up. In addition, literature suggests decreased hospital stay, less blood loss equating to less blood transfusion and a trend towards decreased complications as well. In the near future we would anticipate further refinement and reduced operating times with increased benefits for the patient undergoing RARC.

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Section: Postoperative Complicationsmentioning

confidence: 95%

“…A prospective, randomized, non-inferiority study by Nix et al compared RARC and ORC. They reported a mean lymph node yield of 19 for the RARC group compared to 18 for the ORC group [21]. Analysis of IRCC data has demonstrated a mean lymph node yield of 19.…”

Section: Lymph Node Dissection and Yieldmentioning

confidence: 99%

Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Rao

Stegemann

Rehman

et al. 2012

Indian J Surg Oncol

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“…In various series lesser amount of perioperative blood loss, and decrease in hematocrit levels were indicated when compared with open surgery with an average blood loss ranging between 273, and 473 mL. [19,20] In our series average blood loss was 325 mL, and drop in hematocrit was 3.15% which were within acceptable limits.. As for hospital stays, we think that for a major surgery 12 days should not be considered as a prolonged hospital stay, and as experiences accumulate, lymphatic drainage which develops after lymphadenectomy may be prevented, and drain withdrawal, and discharge times may be performed at an earlier date. Therefore conduction of a randomized study which will compare open, and robotic surgery will be more appropriate.…”

Section: Discussionmentioning

confidence: 99%

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

İslamoğlu

Anıl

Erol

et al. 2018

Turkish Journal of Urology

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Objective: To present the surgical and pathological results of robotic radical cystectomy (RRC) operations performed in our clinic. Material and methods:A total of 18 patients, who underwent RRC and intracorporeal urinary diversion between October 2016 and September 2017 for clinically localized bladder cancer in our clinic, were included in the study. The results were evaluated under three headings. 1. operative outcomes (total operation time, perioperative blood loss, postoperative hematocrit decrease) 2. recovery period (pull-off drain day, hospitalization time) 3. oncological results (pathologic stage, surgical margin, number, and characteristics of lymph nodes removed). Complications within the postoperative 30-day period, were evaluated and the Clavien classification system was used to classify the complications. Results:The mean age of the patients was 64.4 (52-80) years. Seventeen male patients and one female patient underwent robotic cystectomy. At the operative outcomes, the mean blood loss was 325 mL, and the mean hematocrit decrease was 3.15%. The mean duration of the surgery was 471 minutes (330-630), while the median operative time was 450 minutes. Complications occured in 6 patients during the early postoperative period. Six of them (75%) had minor complications (Clavien grade 1), two patients (25%) had major complications (Clavien grade 4). Conclusion:Our initial experience with RRC is that, this surgical technique has acceptable operative, oncological and short-term clinical outcomes. However, prospective randomized studies are needed to assess whether there is a clear advantage compared to open surgery.

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“…Pruthi and colleagues concluded that with their relatively large study to date, SCRRC for the treatment of bladder cancer provided satisfactory outcomes [26]. Nix et al published a subsequent landmark prospective randomized trial of ORC versus SCRRC in 41 patients and discovered that compared with ORC, SCRRC was associated with less intraoperative EBL (258 vs. 575 ml P<0.001), earlier time-to-bowel movement and reduced narcotic use for pain relief [27].…”

Section: Oncological Outcomesmentioning

confidence: 99%

“…Early and intermediate follow up studies has strongly suggested SCRRC may provide similar oncological efficacy but with reduced complications and blood loss [27][28][29].Although long term oncological and functional data is required, SCRRC holds serious promise in eventually becoming standard treatment for localized bladder cancer.…”

Section: Oncological Outcomesmentioning

confidence: 99%

The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

Patel

Babbar

Hemal

2011

Indian J Surg Oncol

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The rise of robotic surgery is transforming medicine. In many ways, urology has taken charge in pioneering a new era of minimally invasive surgery with the emergence of the robot. The unprecedented dissecting precision and the dynamic three-dimensional, high definition view of the surgical field are undoubtedly revolutionizing the field of urology. These unique attributes of robotic surgery confer enormous advantages in dealing with urooncological surgery. The robotic revolution began nearly a decade ago with surgeon-controlled robotic radical prostatectomy and has since expanded to include radical cystectomies and partial nephrectomies. There have been numerous landmark studies published showing that robotic surgery provides comparable oncological and functional outcomes against traditional open or laparoscopic surgery. As a result, it becomes exceedingly imperative that urologists and the oncological community remain up-todate regarding these developments and appreciate the oncological outcomes of surgeon-controlled robotic surgery. This review will assess the impact surgeon-controlled robotic surgery has had in the field of urologic oncology.

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Prospective Randomized Controlled Trial of Robotic versus Open Radical Cystectomy for Bladder Cancer: Perioperative and Pathologic Results

Cited by 488 publications

References 22 publications

Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Status of Robot-Assisted Radical Cystectomy (RARC) in 2012

Robotic radical cystectomy for the management of bladder cancer: Analysis of operative and pathological outcomes of eighteen patient

The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

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