Number of days alive and out of hospital within first 90 days greater for robot-assisted surgery, but clinical significance of findings unclear
TUESDAY, May 17, 2022 (HealthDay News) — For patients with nonmetastatic bladder cancer, robot-assisted radical cystectomy is associated with more days alive and out of the hospital within 90 days of surgery compared with open radical cystectomy, according to a study published online May 15 in the Journal of the American Medical Association to coincide with the annual meeting of the American Urological Association, held from May 13 to 16 in New Orleans.
James W. F. Catto, Ph.D., from the University of Sheffield in the United Kingdom, and colleagues randomly assigned patients with nonmetastatic bladder cancer, recruited from March 2017 to March 2020, to receive either robot-assisted radical cystectomy with intracorporeal reconstruction or open radical cystectomy (169 each).
The researchers found that the median number of days alive and out of the hospital within 90 days of surgery was 82 and 80 among patients undergoing robotic surgery and open surgery, respectively (adjusted difference, 2.2 days). Compared with open surgery, thromboembolic complications (1.9 versus 8.3 percent) and wound complications (5.6 versus 16.0 percent) were less common with robotic surgery. Worse quality of life was reported at five weeks by participants undergoing open versus robotic surgery, and they had greater disability at five and 12 weeks; after 12 weeks, the differences were not significant. No statistically significant differences were seen in cancer recurrence and overall mortality at median follow-up of 18.4 months.
“Whether the benefit in days spent outside of the hospital is clinically meaningful and sufficient to promote further diffusion is likely to be a source of debate, with rational arguments on both sides of quality and cost issues,” write the authors of an accompanying editorial.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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