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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Outcomes of Intracorporeal Urinary Diversion after Robot-Assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium
Journal of Urology, Volume 199, No. 5, Year 2018
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Description
Purpose: This study aimed to provide an update and compare perioperative outcomes and complications of intracorporeal and extracorporeal urinary diversion following robot-assisted radical cystectomy using data from the multi-institutional, prospectively maintained International Robotic Cystectomy Consortium database. Materials and Methods: We retrospectively reviewed the records of 2,125 patients from a total of 26 institutions. Intracorporeal urinary diversion was compared with extracorporeal urinary diversion. Multivariate logistic regression models using stepwise variable selection were fit to evaluate preoperative, operative and postoperative predictors of intracorporeal urinary diversion, operative time, high grade complications and 90-day hospital readmissions after robot-assisted radical cystectomy. Results: In our cohort 1,094 patients (51%) underwent intracorporeal urinary diversion. These patients demonstrated shorter operative time (357 vs 400 minutes), less blood loss (300 vs 350 ml) and fewer blood transfusions (4% vs 19%, all p <0.001). They experienced more high grade complications (13% vs 10%, p = 0.02). Intracorporeal urinary diversion use increased from 9% of all urinary diversions in 2005 to 97% in 2015. Complications after this procedure decreased significantly with time (p <0.001). On multivariable analysis higher annual cystectomy volume (OR 1.02, 95% CI 1.01–1.03, p <0.002), year of robot-assisted radical cystectomy (2013–2016 OR 68, 95% CI 44–105, p <0.001) and American Society of Anesthesiologists® score less than 3 (OR 1.75, 95% CI 1.38–2.22, p <0.001) were associated with undergoing intracorporeal urinary diversion. The procedure was associated with a shorter operative time of 27 minutes (p = 0.001). Conclusions: The use of intracorporeal urinary diversion has increased in the last decade. A higher annual institutional volume of robot-assisted radical cystectomy was associated with intracorporeal urinary diversion as well as with shorter operative time. Although intracorporeal urinary diversion was associated with higher grade complications than extracorporeal urinary diversion, they decreased with time. © 2018 American Urological Association Education and Research, Inc.
Authors & Co-Authors
Hussein, Ahmed Aly
Turkey, Ankara
Ankara Yildirim Beyazit University
May, Paul R.
Turkey, Ankara
Ankara Yildirim Beyazit University
Jing, Zhe
Turkey, Ankara
Ankara Yildirim Beyazit University
Ahmed, Youssef E.
Turkey, Ankara
Ankara Yildirim Beyazit University
Wijburg, Carl J.
Turkey, Ankara
Ankara Yildirim Beyazit University
Canda, Abdullah Erdem
Turkey, Ankara
Ankara Yildirim Beyazit University
Dasgupta, Prokar
Turkey, Ankara
Ankara Yildirim Beyazit University
Menon, Mani M.
Turkey, Ankara
Ankara Yildirim Beyazit University
Peabody, James O.
Turkey, Ankara
Ankara Yildirim Beyazit University
Hosseini, Abolfazl
Turkey, Ankara
Ankara Yildirim Beyazit University
Kelly, John D.
Turkey, Ankara
Ankara Yildirim Beyazit University
Mottrie, Alexandre Marie
Turkey, Ankara
Ankara Yildirim Beyazit University
Kaouk, Jihad H.
Turkey, Ankara
Ankara Yildirim Beyazit University
Hemal, Ash Kumar
Turkey, Ankara
Ankara Yildirim Beyazit University
Wiklund, Peter N.
Turkey, Ankara
Ankara Yildirim Beyazit University
Guru, Khurshid Ahad
Turkey, Ankara
Ankara Yildirim Beyazit University
Wagner, Andrew Aurel
Unknown Affiliation
Saar, Matthias
Unknown Affiliation
Stöckle, Michael
Unknown Affiliation
Redorta, Joan Palou
Unknown Affiliation
Richstone, Lee
Unknown Affiliation
Badani, Ketan K.
Unknown Affiliation
Scherr, Douglas S.
Unknown Affiliation
Khan, Hijab
Unknown Affiliation
Gaboardi, Franco
Unknown Affiliation
Rha, Koonho
Unknown Affiliation
Kawa, Omar
Unknown Affiliation
Tan, Weishen
Unknown Affiliation
Schanne, Francis J.
Unknown Affiliation
Maatman, Thomas J.
Unknown Affiliation
Pini, Giovannalberto
Unknown Affiliation
Peak, Taylor C.
Unknown Affiliation
Kibel, Adam S.
Unknown Affiliation
Yuh, Bertram E.
Unknown Affiliation
Statistics
Citations: 154
Authors: 34
Affiliations: 1
Identifiers
Doi:
10.1016/j.juro.2017.12.045
ISSN:
00225347
Research Areas
Health System And Policy
Study Design
Cohort Study