{Reference Type}: Journal Article
{Title}: Contemporary morbidity and mortality of open versus robotic cystectomy for bladder cancer: An analysis of the National Surgical Quality Improvement Program (NSQIP) procedure targeted cystectomy database.
{Author}: Melchiode Z;Hu S;Xu J;Riveros C;Farooq S;Ranganathan S;Huang E;Miles BJ;Kaushik D;Wallis CJD;Satkunasivam R;
{Journal}: Urol Oncol
{Volume}: 0
{Issue}: 0
{Year}: 2024 May 2
{Factor}: 2.954
{DOI}: 10.1016/j.urolonc.2024.03.017
{Abstract}: <B>OBJECTIVE: </B>To evaluate the association between surgical modality (RARC vs. ORC) and the risk of 30-day complications.<BR><B>METHODS: </B>We utilized the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Cystectomy-Targeted database from 2019 to 2021. The primary outcome was a composite of major complications including 30-day mortality, reoperation, cardiac events, and stroke. Secondary outcomes included individual major and cystectomy-specific complications. Propensity score matching (PSM) was employed to minimize inherent differences within our cohort. We performed logistic regression to assess the association between outcomes of interest and operative modality.<BR><B>RESULTS: </B>We found no difference between operative modality and the primary outcome, however, RARC was associated with a 70% lower risk of 30-day mortality (OR 0.30, 95% CI 0.13-0.70) and had favorable outcomes with respect to respiratory, deep venous thrombosis, wound complications, and length of stay. Limitations are related to residual confounding given the observational methodology.<BR><B>CONCLUSIONS: </B>RARC was associated with reduced risk of multiple 30-day complications, including mortality, as well as organ system and cystectomy-specific outcomes. These data support the clinical benefit of increased adoption of RARC.