Comparison of postoperative and early oncological outcomes of open versus robotic radical cystectomy

To compare the peri-operative and early oncological outcomes between open radical cystectomy and urinary diversion versus robotic radical cystectomy with intracorporal urinary diversion in a large UK regional cystectomy centre. All patients between January 2020 and June 2024 who underwent a radical cystectomy and urinary diversion were identified for a retrospective cohort study. Peri-operative outcomes were compared between the open and robotic groups. Early oncological outcomes, including overall survival, progression-free survival, and cancer-specific survival were analysed at 8 months. There were no significant differences in early oncological outcomes between ORC and RARC. However, the robotic approach was associated with significantly lower estimated blood loss, reduced transfusion rates, and shorter length of hospital stay compared with the open approach. Rates of post-operative complications, as well as 30-day and 90-day readmissions, were comparable between the two groups. Robotic-assisted radical cystectomy demonstrated superior peri-operative outcomes in terms of reduced blood loss, lower transfusion requirements and shorter hospital stay without compromising early oncological outcomes. Further research is required to determine whether these peri-operative advantages translate into long-term oncological benefit and improved quality-adjusted life years sufficient to justify the increased procedural costs associated with the robotic approach.