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Titel: A comparative propensity score-matched analysis of perioperative outcomes of intracorporeal vs extracorporeal urinary diversion after robot-assisted radical cystectomy : results from the International Robotic Cystectomy Consortium
VerfasserIn: Hussein, Ahmed A.
Elsayed, Ahmed S.
Aldhaam, Naif A.
Jing, Zhe
Peabody, James O.
Wijburg, Carl J.
Wagner, Andrew
Canda, Abdullah Erdem
Khan, Mohammad Shamim
Scherr, Douglas
Schanne, Francis
Maatman, Thomas J.
Kim, Eric
Mottrie, Alexandre
Aboumohamed, Ahmed
Gaboardi, Franco
Pini, Giovannalberto
Kaouk, Jihad
Yuh, Bertram
Rha, Koon-Ho
Hemal, Ashok
Palou Redorta, Joan
Badani, Ketan
Saar, Matthias
Stöckle, Michael
Richstone, Lee
Roupret, Morgan
Balbay, Derya
Dasgupta, Prokar
Menon, Mani
Guru, Khurshid A.
Sprache: Englisch
Titel: BJU International
Bandnummer: 126
Heft: 2
Seiten: 265-272
Verlag/Plattform: Wiley
Erscheinungsjahr: 2020
Freie Schlagwörter: intracorporeal
extracorporeal
urinary diversion
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Objective To compare the perioperative outcomes of intracorporeal (ICUD) vs extracorporeal urinary diversion (ECUD) after robot-assisted radical cystectomy (RARC). Patients and Methods We retrospectively reviewed the prospectively maintained International Robotic Cystectomy Consortium (IRCC) database. A total of 972 patients from 28 institutions who underwent RARC were included. Propensity score matching was used to match patients based on age, gender, body mass index (BMI), American Society of Anesthesiologists Score (ASA) score, Charlson Comorbidity Index (CCI) score, prior radiation and abdominal surgery, receipt of neoadjuvant chemotherapy, and clinical staging. Matched cohorts were compared. Multivariate stepwise logistic and linear regression models were fit to evaluate variables associated with receiving ICUD, operating time, 90-day high-grade complications (Clavien–Dindo Classification Grade ≥III), and 90-day readmissions after RARC. Results Utilisation of ICUD increased from 0% in 2005 to 95% in 2018. The ICUD patients had more overall complications (66% vs 58%, P = 0.01) and readmissions (27% vs 17%, P = 0.01), but not high-grade complications (21% vs 24%, P = 0.22). A more recent RC era and ileal conduit diversion were associated with receiving an ICUD. Higher BMI, ASA score ≥3, and receiving a neobladder were associated with longer operating times. Shorter operating time was associated with male gender, older age, ICUD, and centres with a larger annual average RC volume. Longer intensive care unit stay was associated with 90-day high-grade complications. Higher CCI score, prior radiation therapy, neoadjuvant chemotherapy, and ICUD were associated with a higher risk of 90-day readmissions. Conclusions Utilisation of ICUD has increased over the past decade. ICUD was associated with more overall complications and readmissions compared to ECUD, but not high-grade complications.
DOI der Erstveröffentlichung: 10.1111/bju.15083
URL der Erstveröffentlichung: https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.15083
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-377366
hdl:20.500.11880/34126
http://dx.doi.org/10.22028/D291-37736
ISSN: 1464-410X
1464-4096
Datum des Eintrags: 26-Okt-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Urologie und Kinderurologie
Professur: M - Prof. Dr. Michael Stöckle
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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