Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study
<b>Background:</b> Bladder cancer is a common urinary tract malignancy. Minimally invasive radical cystectomy has shown oncological outcomes comparable to the conventional open surgery and with advantages over the open procedure. However, outcomes of the two main minimally invasive proce...
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/3/772 |
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| author | Le-Wei Fan Yun-Ren Li Cheng-Mu Wu Kai-Ti Chuang Wei-Chang Li Chung-Yi Liu Ying-Hsu Chang |
| author_facet | Le-Wei Fan Yun-Ren Li Cheng-Mu Wu Kai-Ti Chuang Wei-Chang Li Chung-Yi Liu Ying-Hsu Chang |
| author_sort | Le-Wei Fan |
| collection | DOAJ |
| description | <b>Background:</b> Bladder cancer is a common urinary tract malignancy. Minimally invasive radical cystectomy has shown oncological outcomes comparable to the conventional open surgery and with advantages over the open procedure. However, outcomes of the two main minimally invasive procedures, robot-assisted and pure laparoscopic, have yet to be compared. This study aimed to compare in-hospital outcomes between these two techniques performed for patients with bladder cancer. <b>Methods:</b> This population-based, retrospective study included hospitalized patients aged ≥ 50 years with a primary diagnosis of bladder cancer who underwent robot-assisted or pure laparoscopic radical cystectomy. All patient data were extracted from the US National Inpatient Sample (NIS) database 2008–2018 and were analyzed retrospectively. Primary outcomes were in-hospital mortality, prolonged length of stay (LOS), and postoperative complications. <b>Results:</b> The data of 3284 inpatients (representing 16,288 US inpatients) were analyzed. After adjusting for confounders, multivariable analysis revealed that patients who underwent robot-assisted radical cystectomy had a significantly lower risk of in-hospital mortality (adjusted OR [aOR], 0.50, 95% CI: 0.28–0.90) and prolonged LOS (aOR, 0.63, 95% CI: 0.49–0.80) than those undergoing pure laparoscopic cystectomy. Patients who underwent robot-assisted radical cystectomy had a lower risk of postoperative complications (aOR, 0.69, 95% CI: 0.54–0.88), including bleeding (aOR, 0.73, 95% CI: 0.54–0.99), pneumonia (aOR, 0.49, 95% CI: 0.28–0.86), infection (aOR, 0.55, 95% CI: 0.36–0.85), wound complications (aOR, 0.33, 95% CI: 0.20–0.54), and sepsis (aOR, 0.49, 95% CI: 0.34–0.69) compared to those receiving pure laparoscopic radical cystectomy. <b>Conclusions:</b> Patients with bladder cancer, robot-assisted radical cystectomy is associated with a reduced risk of unfavorable short-term outcomes, including in-hospital mortality, prolonged LOS, and postoperative complications compared to pure laparoscopic radical cystectomy. |
| first_indexed | 2024-03-08T03:53:17Z |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T03:53:17Z |
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| spelling | doaj.art-02475e9633f044f69dd62ea423f2221e2024-02-09T15:15:59ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113377210.3390/jcm13030772Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database StudyLe-Wei Fan0Yun-Ren Li1Cheng-Mu Wu2Kai-Ti Chuang3Wei-Chang Li4Chung-Yi Liu5Ying-Hsu Chang6Division of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, TaiwanDivision of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, TaiwanDepartment of Biotechnology and Laboratory Science in Medicine, National Tang Ming Chiao Tung University, Taipei 112, TaiwanDivision of Plastic and Reconstructive Surgery, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, TaiwanDivision of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, TaiwanDivision of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, TaiwanDivision of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, Taiwan<b>Background:</b> Bladder cancer is a common urinary tract malignancy. Minimally invasive radical cystectomy has shown oncological outcomes comparable to the conventional open surgery and with advantages over the open procedure. However, outcomes of the two main minimally invasive procedures, robot-assisted and pure laparoscopic, have yet to be compared. This study aimed to compare in-hospital outcomes between these two techniques performed for patients with bladder cancer. <b>Methods:</b> This population-based, retrospective study included hospitalized patients aged ≥ 50 years with a primary diagnosis of bladder cancer who underwent robot-assisted or pure laparoscopic radical cystectomy. All patient data were extracted from the US National Inpatient Sample (NIS) database 2008–2018 and were analyzed retrospectively. Primary outcomes were in-hospital mortality, prolonged length of stay (LOS), and postoperative complications. <b>Results:</b> The data of 3284 inpatients (representing 16,288 US inpatients) were analyzed. After adjusting for confounders, multivariable analysis revealed that patients who underwent robot-assisted radical cystectomy had a significantly lower risk of in-hospital mortality (adjusted OR [aOR], 0.50, 95% CI: 0.28–0.90) and prolonged LOS (aOR, 0.63, 95% CI: 0.49–0.80) than those undergoing pure laparoscopic cystectomy. Patients who underwent robot-assisted radical cystectomy had a lower risk of postoperative complications (aOR, 0.69, 95% CI: 0.54–0.88), including bleeding (aOR, 0.73, 95% CI: 0.54–0.99), pneumonia (aOR, 0.49, 95% CI: 0.28–0.86), infection (aOR, 0.55, 95% CI: 0.36–0.85), wound complications (aOR, 0.33, 95% CI: 0.20–0.54), and sepsis (aOR, 0.49, 95% CI: 0.34–0.69) compared to those receiving pure laparoscopic radical cystectomy. <b>Conclusions:</b> Patients with bladder cancer, robot-assisted radical cystectomy is associated with a reduced risk of unfavorable short-term outcomes, including in-hospital mortality, prolonged LOS, and postoperative complications compared to pure laparoscopic radical cystectomy.https://www.mdpi.com/2077-0383/13/3/772bladder cancerin-hospital outcomenationwide inpatient sample (NIS)radical cystectomyrobot-assisted surgery |
| spellingShingle | Le-Wei Fan Yun-Ren Li Cheng-Mu Wu Kai-Ti Chuang Wei-Chang Li Chung-Yi Liu Ying-Hsu Chang Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study Journal of Clinical Medicine bladder cancer in-hospital outcome nationwide inpatient sample (NIS) radical cystectomy robot-assisted surgery |
| title | Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study |
| title_full | Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study |
| title_fullStr | Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study |
| title_full_unstemmed | Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study |
| title_short | Inpatient Outcomes of Patients Undergoing Robot-Assisted versus Laparoscopic Radical Cystectomy for Bladder Cancer: A National Inpatient Sample Database Study |
| title_sort | inpatient outcomes of patients undergoing robot assisted versus laparoscopic radical cystectomy for bladder cancer a national inpatient sample database study |
| topic | bladder cancer in-hospital outcome nationwide inpatient sample (NIS) radical cystectomy robot-assisted surgery |
| url | https://www.mdpi.com/2077-0383/13/3/772 |
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