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- Title
Impact of outcomes and costs for implementation of robotic radical cystectomy with full intracorporeal urinary diversion.
- Authors
Rahota, Razvan George; Beauval, Jean-Baptiste; Gautier, Jean-Romain; Almeras, Christophe; Garnault, Valerie; Loison, Guillaume; Salin, Ambroise; Tollon, Christophe; Ploussard, Guillaume
- Abstract
Introduction Radical cystectomy (RC) remains a surgery with important morbidity despite technical advances. Our aim was to determine the impact on outcomes and costs of robot-assisted radical cystectomy (RARC) with full intracorporeal diversion. Material and methods We retrospectively included 196 consecutive patients undergone RC for bladder cancer between 2017 and 2022. Comparisons were done between the open radical cystectomy (ORC; n = 166) and RARC with full intracorporeal diversion (n = 30) in the overall cohort and after matched pair analysis. Results More neobladders were performed in the RARC group (40% vs 18.7%, p = 0.011). Peri-operative parameters continuously improved over time in the RARC cohort despite an increased proportion of elderly patients with higher comorbidity index. RARC patients had lower prolonged stay (33.3% vs 68.3%, p = 0.002), lower grade 1 complication rates (26.7% vs 53.3%, p = 0.016) and blood loss (185 vs 611 ml, p <0.001) than ORC patients. RARC was an independent favorable predictor for prolonged stay (OR 0.199) and complication (OR 0.334). Cost balance favored ORC, with an increase of hospitalization cost at 816 euros for RARC. Conclusions After matching, RARC with full intracorporeal diversion was associated with improved outcomes and a moderated increase of post-operative costs mainly due to the use of robotic devices.
- Subjects
CYSTECTOMY; BLADDER cancer; PARAMETER estimation; HOSPITAL costs; ENHANCED recovery after surgery protocol
- Publication
Central European Journal of Urology (2080-4806), 2023, Vol 76, Issue 4, p305
- ISSN
2080-4806
- Publication type
Article
- DOI
10.5173/ceju.2023.203