+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample



Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample



European Urology 61(6): 1239-1244



Although robot-assisted laparoscopic radical cystectomy (RARC) was first reported in 2003 and has gained popularity, comparisons with open radical cystectomy (ORC) are limited to reports from high-volume referral centers. To compare population-based perioperative outcomes and costs of ORC and RARC. A retrospective observational cohort study using the US Nationwide Inpatient Sample to characterize 2009 RARC compared with ORC use and outcomes. Propensity score methods were used to compare inpatient morbidity and mortality, lengths of stay, and costs. We identified 1444 ORCs and 224 RARCs. Women were less likely to undergo RARC than ORC (9.8% compared with 15.5%, p = 0.048), and 95.7% of RARCs and 73.9% of ORCs were performed at teaching hospitals (p<0.001). In adjusted analyses, subjects undergoing RARC compared with ORC experienced fewer inpatient complications (49.1% and 63.8%, p = 0.035) and fewer deaths (0% and 2.5%, p<0.001). RARC compared with ORC was associated with lower parenteral nutrition use (6.4% and 13.3%, p = 0.046); however, there was no difference in length of stay. RARC compared with ORC was $3797 more costly (p = 0.023). Limitations include retrospective design, absence of tumor characteristics, and lack of outcomes beyond hospital discharge. RARC is associated with lower parenteral nutrition use and fewer inpatient complications and deaths. However, lengths of stay are similar, and the robotic approach is significantly more costly.

(PDF emailed within 0-6 h: $19.90)

Accession: 052209194

Download citation: RISBibTeXText

PMID: 22482778

DOI: 10.1016/j.eururo.2012.03.032


Related references

Systematic review and meta-analysis of comparative studies reporting early outcomes after robot-assisted radical cystectomy versus open radical cystectomy. Cancer Treatment Reviews 39(6): 551-560, 2013

PE68: Perioperative outcomes of neoadjuvant chemotherapy versus radical cystectomy in patients treated with robot-assisted radical cystectomy: Results from the International Robotic Cystectomy Consortium (IRCC). European Urology Supplements 13(3): 41-42, 2014

Randomized Trial Comparing Open Radical Cystectomy and Robot-assisted Laparoscopic Radical Cystectomy: Oncologic Outcomes. European Urology 74(4): 465-471, 2018

PE49: Robot-Assisted Radical Cystectomy (RARC) results in lower costs and less complications as compared to Open Radical Cystectomy (ORC). European Urology Supplements 13(3): 32-33, 2014

Multicentric comparison of surgical outcomes obtained after open radical cystectomy and robot-assisted laparoscopic radical cystectomy for muscle-invasive bladder cancer. European Urology Supplements 17(2): E1027-E1028, 2018

Multidomain Quantitative Recovery Following Radical Cystectomy for Patients Within the Robot-assisted Radical Cystectomy with Intracorporeal Urinary Diversion Versus Open Radical Cystectomy Randomised Controlled Trial: The First 30 Patients. European Urology 74(4): 531-534, 2018

Robot-assisted radical cystectomy versus open radical cystectomy: a complete cost analysis. Urology 77(3): 621-625, 2011

Cost analysis of open radical cystectomy versus robot-assisted radical cystectomy. Bju International 121(3): 437-444, 2017

Cost analysis of open radical cystectomy versus robot-assisted radical cystectomy. Current Urology Reports 14(1): 26-31, 2013

Robot assisted radical cystectomy versus open radical cystectomy in bladder cancer (RACE): study protocol of a non-randomized comparative effectiveness study. Bmc Cancer 18(1): 861, 2018

Comparing Open Radical Cystectomy and Robot-assisted Laparoscopic Radical Cystectomy: A Randomized Clinical Trial. European Urology 67(6): 1042-1050, 2016

Does previous robot-assisted radical prostatectomy experience affect outcomes at robot-assisted radical cystectomy? Results from the International Robotic Cystectomy Consortium. Urology 76(5): 1111-1116, 2010

Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial. Lancet 391(10139): 2525-2536, 2018

Robot-assisted radical cystectomy versus open radical cystectomy: assessment of postoperative pain. Canadian Journal of Urology 14(6): 3753-3756, 2008

Robot-assisted radical cystectomy with intracorporeal urinary diversion versus open radical cystectomy (iROC): protocol for a randomised controlled trial with internal feasibility study. Bmj Open 8(8): E020500, 2018