Abstract
Introduction
We aimed to compare short term outcomes after robot assisted radical cystectomy (RARC)
and open radical cystectomy (ORC) for urinary bladder cancer in a large population.
Materials and methods
We included all patients without distant metastases who underwent either RARC or ORC
with ileal conduit between 2011 and 2019 registered in the Bladder cancer data Base
Sweden (BladderBaSe) 2.0. Primary outcome was unplanned readmissions within 90 days,
and secondary outcomes within 90 days of surgery were reoperations, Clavien 3–5 complications,
total days alive and out of hospital, and mortality. The analysis was carried out
using multivariate regression models.
Results
Out of 2905 patients, 832 were operated with RARC and 2073 with ORC. Robotic procedures
were to a larger extent performed during later years, at high volume centers (47%
vs 17%), more often for organ-confined disease (82% vs. 72%) and more frequently in
patients with high socioeconomic status (26% vs. 21%). Patients operated with RARC
were more commonly readmitted (29% vs. 25%). In multivariable analysis RARC was associated
with decreased risk of Clavien 3–5 complications (OR 0.58, 95% CI 0.47–0.72), reoperations
(OR 0.53, 95% CI 0.39–0.71) and had more days alive and out of hospital (mean difference
3.7 days, 95% CI 2.4–5.0).
Conclusion
This study illustrates the “real-world” effects of a gradual and nation-wide introduction
of RARC. Patients operated with RARC had fewer major complications and reoperations
but were more frequently readmitted compared to ORC. The observed differences were
largely due to more wound related complications among patients treated with ORC.
Keywords
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Article info
Publication history
Accepted:
January 23,
2023
Received in revised form:
January 11,
2023
Received:
November 9,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
