892 PRELIMINARY RESULTS OF PERIOPERATIVE OUTCOMES AND ONOCOLIGIC EFFICACY FROM A SINGLE INSTITUTION RANDOMIZED CONTROLLED TRIAL OF OPEN VERSUS ROBOTIC ASSISTED RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Basic Research II1 Apr 2012892 PRELIMINARY RESULTS OF PERIOPERATIVE OUTCOMES AND ONOCOLIGIC EFFICACY FROM A SINGLE INSTITUTION RANDOMIZED CONTROLLED TRIAL OF OPEN VERSUS ROBOTIC ASSISTED RADICAL CYSTECTOMY Jamie Messer, John Fitzgerald, Barbara Ercole, Robert Svatek, and Dipen Parekh Jamie MesserJamie Messer San Antonio, TX More articles by this author , John FitzgeraldJohn Fitzgerald San Antonio, TX More articles by this author , Barbara ErcoleBarbara Ercole San Antonio, TX More articles by this author , Robert SvatekRobert Svatek San Antonio, TX More articles by this author , and Dipen ParekhDipen Parekh San Antonio, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.987AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic assisted Radical Cystectomy (RARC) for bladder cancer has been reported with the promise for improvement in perioperative morbidity compared to open approach. However, most studies are retrospective with significant selection bias. Our objective was to determine feasibility of conducting a prospective randomized trial comparing robotic to the open approach. We present preliminary data from a single institution prospective randomized clinical trial of open radical cystectomy (ORC) versus RARC. METHODS Prospective randomized single institution series evaluating the feasibility of ORC versus RARC for consecutive patients was performed from July 2009 to June 2011. Oncologic efficacy was assessed based on the surrogates of total number of lymph nodes removed and positive surgical margins. Perioperative morbidity was assessed evaluating for estimated blood loss, transfusion requirements, length of stay and perioperative complications. RESULTS To date 46 patients have been randomized with data available on 39 patients for analysis. Each group was similar with regards to age, sex, race, BMI, comorbidities, and previous abdominal procedures, operative time, and final pathologic stage. We observed no significant difference between oncologic outcomes of positive surgical margins (5% vs 5.263%, p 0.97) or number of LN removed (11 vs 23, p 0.40) for the RARC versus ORC groups respectively. The RARC group was noted to have decreased estimated blood loss (400 mL vs 800 mL, p 0.008) and a trend towards decreased rate of excessive length of stay (>5 days) (65% vs 84%, p 0.24) for the RARC versus ORC groups. The robotic group had a trend towards decreased rate of transfusion however this was not statistically significant (40% versus 53%, p 0.429). CONCLUSIONS Our study confirms feasibility of randomizing patients undergoing radical cystectomy to open or robotic approach. Our preliminary findings from a single institution randomized trial of RARC versus ORC indicates that RARC has equivalent oncologic outcomes as measured by positive surgical margins and total number of lymph node removed. RARC demonstrates perioperative benefits of decreased blood loss, fewer excessive hospital stays, and a trend toward fewer blood transfusions. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e363 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jamie Messer San Antonio, TX More articles by this author John Fitzgerald San Antonio, TX More articles by this author Barbara Ercole San Antonio, TX More articles by this author Robert Svatek San Antonio, TX More articles by this author Dipen Parekh San Antonio, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...