Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy
ABSTRACT Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and i...
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Urologia
2024-04-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000200178&tlng=en |
| _version_ | 1797216784710893568 |
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| author | Hangcheng Fu Laura Davis Venkat Ramakrishnan Thomas Barefoot Colleen Sholtes Lifan Liang Mohammed Said Jamie Messer |
| author_facet | Hangcheng Fu Laura Davis Venkat Ramakrishnan Thomas Barefoot Colleen Sholtes Lifan Liang Mohammed Said Jamie Messer |
| author_sort | Hangcheng Fu |
| collection | DOAJ |
| description | ABSTRACT Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches. Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed. Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate. Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings. |
| first_indexed | 2024-04-24T11:51:28Z |
| format | Article |
| id | doaj.art-a9c2b08fbf204644aacaf46b32c57000 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-24T11:51:28Z |
| publishDate | 2024-04-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-a9c2b08fbf204644aacaf46b32c570002024-04-09T07:41:39ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192024-04-0150217819110.1590/s1677-5538.ibju.2023.0477Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic CystectomyHangcheng Fuhttps://orcid.org/0000-0002-1109-6621Laura DavisVenkat RamakrishnanThomas BarefootColleen SholtesLifan LiangMohammed SaidJamie MesserABSTRACT Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches. Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed. Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate. Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000200178&tlng=enUrinary Bladder NeoplasmsRobotic Surgical ProceduresUrinary Diversion |
| spellingShingle | Hangcheng Fu Laura Davis Venkat Ramakrishnan Thomas Barefoot Colleen Sholtes Lifan Liang Mohammed Said Jamie Messer Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy International Brazilian Journal of Urology Urinary Bladder Neoplasms Robotic Surgical Procedures Urinary Diversion |
| title | Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy |
| title_full | Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy |
| title_fullStr | Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy |
| title_full_unstemmed | Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy |
| title_short | Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy |
| title_sort | identify risk factors for perioperative outcomes in intracorporeal urinary diversion and extracorporeal urinary diversion with robotic cystectomy |
| topic | Urinary Bladder Neoplasms Robotic Surgical Procedures Urinary Diversion |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382024000200178&tlng=en |
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