Open versus robotic radical cystectomy with intracorporeal studer diversion

Abstract

Background and Objectives: To compare open versus totally intracorporeal robotic-assisted radical cystectomy, bilateral extended pelvic lymph node dissection, and Studer urinary diversion in bladder cancer patients. Methods: A retrospective comparison of open (n = 42) versus totally intracorporeal (n = 32) robotic-assisted radical cystectomy, bilateral extended pelvic lymph node dissection, and Studer urinary diversion was performed concerning patient demographic data, operative and postoperative parameters, pathologic parameters, complications, and functional outcomes. Results: Patient demographic data and the percentages of patients with pT2 disease or lower and pT3–pT4 disease were similar between groups (P >.05). Positive surgical margin rates were similar between the open (n = 1, 2.4%) and robotic (n = 2, 6.3%) groups (P >.05). Minor and major complication rates were similar between groups (P >.05). Mean estimated blood loss was significantly lower in the robotic group (412.5 ± 208.3 mL vs 1314.3 ± 987.1 mL, P.05) and severe daytime incontinence (8.3% vs 16.6%, P >.05). No significant differences were detected regarding postoperative mean International Index of Erectile Function scores between groups (P >.05). Conclusions: Robotic surgery has the advantages of decreased blood loss, better preservation of neurovascular bundles, an increased lymph node yield, a decreased rate of hospital readmissions for minor complications, and a better trend for improved daytime continence when compared with the open approach.