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Abstract 1530 : A comparison of postoperative complications in open versus robotic cystectomy

1.1. Abstract 1530 : A comparison of postoperative complications in open versus robotic cystectomy. Casey K. Ng, Eric C. Kauffman, Ming-Ming Lee, Brandon J. Otto, Alyse Portnoff, Josh R. Ehrlich, Gerald J. Wang, Douglas S. Scherr Department of Urology - Weill Cornell Medical College,

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Abstract 1530 : A comparison of postoperative complications in open versus robotic cystectomy

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  1. 1.1 Abstract 1530: A comparison of postoperative complications in open versus robotic cystectomy Casey K. Ng, Eric C. Kauffman, Ming-Ming Lee, Brandon J. Otto, Alyse Portnoff, Josh R. Ehrlich, Gerald J. Wang, Douglas S. Scherr Department of Urology - Weill Cornell Medical College, New York Presbyterian Hospital New York, New York, USA Weill Cornell

  2. Introduction - Robotic Cystectomy • Robotic / laparoscopic radical cystectomy can be performed safely. (Parro 1992, Sanchez de Badajoz 1995, Gill 2000,) • Robotic radical cystectomy has been shown to reduce blood loss and length of stay. (Menon 2003, Balaji 2004, Wang 2007, Pruthi 2007, Galich 2006) • But So What? (Skinner 2007, Herr 2007, Soloway 2007…)

  3. Three Questions • Can it be done? • Should it be done? • Does it provide oncologic control? • Does it provide any benefits over the old way of doing things? • Can everyone do it?

  4. Complications after cystectomy • Complication rate after cystectomy was previously reported at 28% to 39%. (Stein 2001, Hautmann 1999, Lee 2004) • However, recent studies have shown that the true complication rate may be higher. • Vanderbilt reported a 30-day postoperative complication rate of 41%, and MSKCC reported a 90-day postoperative complication rate of 64%. (Lowrance 2008, Shabsigh 2008)

  5. Objective: To compare complications in patients undergoing robotic and open radical cystectomy. Methods: Records of 187 consecutive radical cystectomies, 104 open cystectomies (OC), 83 robotic cystectomies (RC) were evaluated. 30-day and 90-day complication data were compiled and graded using the modified-Clavien complication scale. Chi-squared test was used to analyze categorical data, and multivariate logistic regression was used to determine independent predictors of complications.

  6. Conclusion: • Robotic cystectomy is associated with fewer overall and major complications at 30 days. • Robotic cystectomy is associated with fewer major complications at 90 days. • This reduction in complication rate may be explained in part by lower blood loss in robotic cystectomies.

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