BACKGROUND: Japanese patients who undergo radical cystectomy have a unique feature, i.e., the ratio of octogenarians is higher than in Western patients because of the aging Japanese population. The purpose of this study was to compare perioperative outcomes, complications, and oncologic outcomes between robot-assisted radical cystectomy and open radical cystectomy. METHODS: From 2010-2015, 20 (of which 8 were octogenarians) and 40 (of which 11 were octogenarians) patients underwent robot-assisted radical cystectomy and open radical cystectomy, respectively. RESULTS: There was no significant difference in terms of patient demographics between the two surgical cohorts, regardless of patient age. In the octogenarian patient cohort, the rates of previous abdominal surgery and the median age-adjusted Charlson comorbidity index were higher. The median estimated blood loss, transfusion rate and the days to resumption of a regular diet were significantly lower in the robot-assisted radical cystectomy cohort, regardless of patient age. Robot-assisted radical cystectomy significantly decreased grade II or higher complications, but there were no significant differences in terms of decreasing grade III or higher complications, regardless of patient age. Positive surgical margin and the mean number of lymph nodes removed were similar between the two surgical cohorts, regardless of patient age. CONCLUSION: Although robot-assisted radical cystectomy has a short history in Japan, the outcomes were generally comparable to those of previous studies. In a country that is aging rapidly like Japan, robot-assisted radical cystectomy could be a valid option for the management of muscle-invasive and high-risk superficial bladder cancer.
BACKGROUND: Japanese patients who undergo radical cystectomy have a unique feature, i.e., the ratio of octogenarians is higher than in Western patients because of the aging Japanese population. The purpose of this study was to compare perioperative outcomes, complications, and oncologic outcomes between robot-assisted radical cystectomy and open radical cystectomy. METHODS: From 2010-2015, 20 (of which 8 were octogenarians) and 40 (of which 11 were octogenarians) patients underwent robot-assisted radical cystectomy and open radical cystectomy, respectively. RESULTS: There was no significant difference in terms of patient demographics between the two surgical cohorts, regardless of patient age. In the octogenarian patient cohort, the rates of previous abdominal surgery and the median age-adjusted Charlson comorbidity index were higher. The median estimated blood loss, transfusion rate and the days to resumption of a regular diet were significantly lower in the robot-assisted radical cystectomy cohort, regardless of patient age. Robot-assisted radical cystectomy significantly decreased grade II or higher complications, but there were no significant differences in terms of decreasing grade III or higher complications, regardless of patient age. Positive surgical margin and the mean number of lymph nodes removed were similar between the two surgical cohorts, regardless of patient age. CONCLUSION: Although robot-assisted radical cystectomy has a short history in Japan, the outcomes were generally comparable to those of previous studies. In a country that is aging rapidly like Japan, robot-assisted radical cystectomy could be a valid option for the management of muscle-invasive and high-risk superficial bladder cancer.
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Authors: Kamran Ahmed; Shahid A Khan; Matthew H Hayn; Piyush K Agarwal; Ketan K Badani; M Derya Balbay; Erik P Castle; Prokar Dasgupta; Reza Ghavamian; Khurshid A Guru; Ashok K Hemal; Brent K Hollenbeck; Adam S Kibel; Mani Menon; Alex Mottrie; Kenneth Nepple; John G Pattaras; James O Peabody; Vassilis Poulakis; Raj S Pruthi; Joan Palou Redorta; Koon-Ho Rha; Lee Richstone; Matthias Saar; Douglas S Scherr; Stefan Siemer; Michael Stoeckle; Eric M Wallen; Alon Z Weizer; Peter Wiklund; Timothy Wilson; Michael Woods; Muhammad Shamim Khan Journal: Eur Urol Date: 2013-10-09 Impact factor: 20.096
Authors: Takehiro Iwata; Shoji Kimura; Beat Foerster; Nicola Fossati; Alberto Briganti; Pierre I Karakiewicz; Kilian M Gust; Shin Egawa; Yasutomo Nasu; Mohammad Abufaraj; Shahrokh F Shariat Journal: World J Urol Date: 2019-04-11 Impact factor: 4.226