Is robot-assisted radical cystectomy superior to standard open radical cystectomy? An Indian perspective
| Autor: | Prem B Singh, Ajay K. Dewan, Amitabh Singh, Dharma Ram, Suhas Kodasoge Rajappa, Sudhir Rawal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Blood transfusion medicine.medical_treatment 030232 urology & nephrology lcsh:Surgery India Context (language use) Cystectomy 03 medical and health sciences 0302 clinical medicine Blood loss robotic-assisted radical cystectomy medicine lcsh:RC799-869 Prospective cohort study open radical cystectomy urothelial carcinoma Bladder cancer Carcinoma bladder business.industry Standard treatment lcsh:RD1-811 medicine.disease Surgery 030220 oncology & carcinogenesis Original Article lcsh:Diseases of the digestive system. Gastroenterology business |
| Zdroj: | Journal of Minimal Access Surgery, Vol 14, Iss 4, Pp 298-303 (2018) Journal of Minimal Access Surgery |
| ISSN: | 1998-3921 0972-9941 |
| Popis: | Introduction: Open radical cystectomy (ORC) has been the standard treatment for muscle-invasive bladder cancer, but this is associated with significant morbidity and mortality. Robot-assisted radical cystectomy (RARC) has been proposed as minimally invasive alternative with improved morbidity and acceptable oncological outcomes, but a large series featuring RARC and their comparison with ORC is still lacking in India despite more than a decade of its inception. We have conducted this study with an objective to see the feasibility of RARC in the Indian context and compare it with contemporary standard. Methods: This is a prospective cohort study conducted at two tertiary cancer institutes. We have evaluated the patients pertaining to operative and early post-operative factors from January 2014 to December 2015. Necessary statistical tests applied to see comparability of the arms and their outcomes. Results: A total of 170 patients underwent surgery for carcinoma bladder (45 ORC while 125 RARC). Intraoperative blood loss (RARC and ORC: 228 and 529 ml) and average transfusion rate were lower with RARC. A trend towards benefit was noted in favour of robotic arm in terms of mean complication rate (RARC and ORC: 54 and 39%). Conclusions: The present study has shown comparable surgical and early post-operative outcomes with clear advantage of robotic approach in terms of intraoperative blood transfusion and lymph node yield. Although the study was non-randomised in nature, it should provide substantial evidence on safety and feasibility of RARC in the Indian context and a reference point of evidence to look ahead. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|