Analysis of Complications After Robot-Assisted Radical Cystectomy Between 2002-2021

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical cystectomy (RARC) is increasingly utilized for bladder cancer treatment.
• Understanding postoperative complication trends is crucial for optimizing patient outcomes and surgical techniques.

Purpose of the Study:

• To analyze trends in overall and high-grade postoperative complications following RARC.
• To identify specific complication types that have changed over time.
• To determine factors associated with high-grade complications in RARC patients.

Main Methods:

• Retrospective review of the International Robotic Cystectomy Consortium (IRCC) database (2976 patients, 26 institutions).
• Complications categorized as overall or high-grade (Clavien Dindo ≥ III) and by organ site.
• Descriptive statistics, multivariate analysis (MVA), and Cochran-Armitage trend test were employed.

Main Results:

• 60% of patients experienced postoperative complications; 28% had high-grade complications.
• Gastrointestinal and neurologic complications significantly increased (2005-2020), while thromboembolic and wound complications decreased.
• Factors associated with high-grade complications included higher BMI, prior abdominal surgery, neobladder, positive nodal disease, longer inpatient stay, and ICU admission.

Conclusions:

• Postoperative complication rates following RARC have remained stable between 2002-2021.
• There is an observed increase in gastrointestinal and neurologic complications, contrasted by a decrease in thromboembolic and wound complications.
• Identifying associated risk factors aids in mitigating high-grade complications after RARC.