TY - JOUR
T1 - Analysis of Complications After Robot-Assisted Radical Cystectomy Between 2002-2021
AU - Houenstein, Holly Ann
AU - Jing, Zhe
AU - Elsayed, Ahmed S.
AU - Ramahi, Yousuf O.
AU - Stöckle, Michael
AU - Wijburg, Carl
AU - Hosseini, Abolfazl
AU - Wiklund, Peter
AU - Kim, Eric
AU - Kaouk, Jihad
AU - Dasgupta, Prokar
AU - Khan, Mohammed S.
AU - Wagner, Andrew A.
AU - Syed, Johar R.
AU - Peabody, James O.
AU - Badani, Ketan
AU - Richstone, Lee
AU - Mottrie, Alexandre
AU - Maatman, Thomas J.
AU - Balbay, Derya
AU - Redorta, Juan P.
AU - Rha, Koon Ho
AU - Gaboardi, Franco
AU - Rouprêt, Morgan
AU - Aboumohamed, Ahmed
AU - Hussein, Ahmed A.
AU - Guru, Khurshid A.
N1 - Publisher Copyright:
© 2022
PY - 2023/1
Y1 - 2023/1
N2 - Objective: To identify trends in complications following robot-assisted radical cystectomy (RARC) using a multi-institutional database, the International Robotic Cystectomy Consortium (IRCC). Methods: A retrospective review of the IRCC database was performed (2976 patients, 26 institutions from 11 countries). Postoperative complications were categorized as overall or high grade (≥ Clavien Dindo III) and were further categorized based on type/organ site. Descriptive statistics was used to summarize the data. Multivariate analysis (MVA) was used to identify variables associated with overall and high-grade complications. Cochran-Armitage trend test was used to describe the trend of complications over time. Results: 1777 (60%) patients developed postoperative complications following RARC, 51% of complications occurred within 30 days of RARC, 19% between 30-90 days, and 30% after 90 days. 835 patients (28%) experienced high-grade complications. Infectious complications (25%) were the most prevalent, while bleeding (1%) was the least. The incidence of complications was stable between 2002-2021. Gastrointestinal and neurologic postoperative complications increased significantly (P < .01, for both) between 2005 and 2020 while thromboembolic (P = .03) and wound complications (P < .01) decreased. On MVA, BMI (OR 1.03, 95%CI 1.01-1.05, P < .01), prior abdominal surgery (OR 1.26, 95%CI 1.03-1.56, P = .03), receipt of neobladder (OR 1.52, 95%CI 1.17-1.99, P < .01), positive nodal disease (OR 1.33, 95%CI 1.05-1.70, P = .02), length of inpatient stay (OR 1.04, 95%CI 1.02-1.05, P < .01) and ICU admission (OR 1.67, 95%CI 1.36-2.06, P < .01) were associated with high-grade complications. Conclusion: Overall and high-grade complications after RARC remained stable between 2002-2021. GI and neurologic complications increased, while thromboembolic and wound complications decreased.
AB - Objective: To identify trends in complications following robot-assisted radical cystectomy (RARC) using a multi-institutional database, the International Robotic Cystectomy Consortium (IRCC). Methods: A retrospective review of the IRCC database was performed (2976 patients, 26 institutions from 11 countries). Postoperative complications were categorized as overall or high grade (≥ Clavien Dindo III) and were further categorized based on type/organ site. Descriptive statistics was used to summarize the data. Multivariate analysis (MVA) was used to identify variables associated with overall and high-grade complications. Cochran-Armitage trend test was used to describe the trend of complications over time. Results: 1777 (60%) patients developed postoperative complications following RARC, 51% of complications occurred within 30 days of RARC, 19% between 30-90 days, and 30% after 90 days. 835 patients (28%) experienced high-grade complications. Infectious complications (25%) were the most prevalent, while bleeding (1%) was the least. The incidence of complications was stable between 2002-2021. Gastrointestinal and neurologic postoperative complications increased significantly (P < .01, for both) between 2005 and 2020 while thromboembolic (P = .03) and wound complications (P < .01) decreased. On MVA, BMI (OR 1.03, 95%CI 1.01-1.05, P < .01), prior abdominal surgery (OR 1.26, 95%CI 1.03-1.56, P = .03), receipt of neobladder (OR 1.52, 95%CI 1.17-1.99, P < .01), positive nodal disease (OR 1.33, 95%CI 1.05-1.70, P = .02), length of inpatient stay (OR 1.04, 95%CI 1.02-1.05, P < .01) and ICU admission (OR 1.67, 95%CI 1.36-2.06, P < .01) were associated with high-grade complications. Conclusion: Overall and high-grade complications after RARC remained stable between 2002-2021. GI and neurologic complications increased, while thromboembolic and wound complications decreased.
UR - http://www.scopus.com/inward/record.url?scp=85145954841&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85145954841&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2022.08.049
DO - 10.1016/j.urology.2022.08.049
M3 - Article
C2 - 36241062
AN - SCOPUS:85145954841
SN - 0090-4295
VL - 171
SP - 133
EP - 139
JO - Urology
JF - Urology
ER -