title: A comparison of preliminary oncologic outcome and postoperative complications between patients undergoing either open or robotic radical cystectomy.
abstract: OBJECTIVE
  To compare complications and outcomes in patients undergoing either open radical cystectomy (ORC) or robotic-assisted radical cystectomy (RRC).
  
  
  METHODS
  We retrospectively identified patients that underwent ORC or RRC between 2003- 2013. We statistically compared preliminary oncologic outcomes of patients for each surgical modality.
  
  
  RESULTS
  92 (43.2%) and 121 (56.8%) patients underwent ORC and RRC, respectively. While operative time was shorter for ORC patients (403 vs. 508 min; p<0.001), surgical blood loss and transfusion rates were significantly lower in RRC patients (p<0.001 and 0.006). Length of stay was not different between groups (p=0.221). There was no difference in the proportion of lymph node-positive patients between groups. However, RRC patients had a greater number of lymph nodes removed during surgery (18 vs. 11.5; p<0.001). There was no significant difference in the incidence of pre-existing comorbidities or in the Clavien distribution of complications between groups. ORC and RRC patients were followed for a median of 1.38 (0.55-2.7) and 1.40 (0.58-2.59) years, respectively (p=0.850). During this period, a lower proportion (22.3%) of RRC patients experienced disease recurrence vs. ORC patients (34.8%). However, there was no significant difference in time to recurrence between groups. While ORC was associated with a higher all-cause mortality rate (p=0.049), there was no significant difference in disease-free survival time between groups.
  
  
  CONCLUSIONS
  ORC and RRC patients experience postoperative complications of similar rates and severity. However, RRC may offer indirect benefits via reduced surgical blood loss and need for transfusion.
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Antonio
authors: A
authors: Cusano
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Peter
authors: P
authors: Haddock
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Max
authors: M
authors: Jackson
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Ilene
authors: I
authors: Staff
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Joseph
authors: J
authors: Wagner
authors: Urology Division, Hartford Healthcare Medical Group, Hartford, USA.
authors: Anoop
authors: A
authors: Meraney
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D015897:Comorbidity; D015653:Cystectomy / Q000009:adverse effects / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Postoperative Period; Robotics; Urinary Bladder Neoplasms