A comparative study of robot-assisted laparoscopic intracorporeal versus open urinary diversion
Mahmoud I Khalil1, Ehab Eltahawy1, Jonathan Bauer-Erickson2, Ahmed Farouk3, Sherif Mourad3, Rodney Davis2, Mohamed H Kamel1
1 Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; Department of Urology, Ain Shams University, Cairo, Egypt
2 Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
3 Department of Urology, Ain Shams University, Cairo, Egypt
Mohamed H Kamel,
Department of Urology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, Arkansas 72205
Source of Support: None, Conflict of Interest: None
Aims: Robot-assisted laparoscopic intracorporeal urinary diversion (ICUD) has several potential benefits of a smaller incision and reduced pain over extracorporeal urinary diversion (ECUD). We compared the perioperative outcomes of patients who have undergone these procedures with or without cystectomy.
Subjects and Methods: This study is a retrospective chart review of patients who underwent ICUD and ECUD in a single tertiary referral hospital. Patient demographics, perioperative outcomes, and the 90-day postoperative complications were collected.
Statistical Analysis Used: The statistical analyses were performed using the Chi-square test for categorical variables which are specified as frequency (percentage).
Results: Thirty-five patients who underwent urinary diversion procedure were identified for inclusion in the study. Of these patients, 14 underwent ICUD and 21 underwent ECUD. The mean operative time was longer in the ICUD group compared to that of the ECUD (457.14 ± 103.91 and 388.29 ± 110.17, respectively, P = 0.07). The median blood loss was statistically significantly lower in the ICUD group (250 ml) than in the ECUD group (450 ml, P = 0.05). The mean hospital stay was marginally longer for the ECUD group (8.1 days) as compared to the ICUD group (6.3 days, P = 0.17). There was no difference in the readmission or reoperation rates after 30 days. The 90-day complication rate was not statistically significantly different between the two groups, but a trend favoring ICUD (64%) over ECUD (71%, P = 0.656) was noted.
Conclusions: Robot-assisted ICUD is associated with decreased blood loss, and there is a trend toward fewer postoperative complications and shorter hospital stays.