To evaluate the association between surgical modality (RARC vs. ORC) and the risk of 30-day complications.
We utilized the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Cystectomy-Targeted database from 2019 to 2021. The primary outcome was a composite of major complications including 30-day mortality, reoperation, cardiac events, and stroke. Secondary outcomes included individual major and cystectomy-specific complications. Propensity score matching (PSM) was employed to minimize inherent differences within our cohort. We performed logistic regression to assess the association between outcomes of interest and operative modality.
We found no difference between operative modality and the primary outcome, however, RARC was associated with a 70% lower risk of 30-day mortality (OR 0.30, 95% CI 0.13-0.70) and had favorable outcomes with respect to respiratory, deep venous thrombosis, wound complications, and length of stay. Limitations are related to residual confounding given the observational methodology.
RARC was associated with reduced risk of multiple 30-day complications, including mortality, as well as organ system and cystectomy-specific outcomes. These data support the clinical benefit of increased adoption of RARC.
Urologic oncology. 2024 May 02 [Epub ahead of print]
Zachary Melchiode, Siqi Hu, Jiaqiong Xu, Carlos Riveros, Sameer Farooq, Sanjana Ranganathan, Emily Huang, Brian J Miles, Dharam Kaushik, Christopher J D Wallis, Raj Satkunasivam
Department of Urology, Houston Methodist Hospital, Houston, TX., Center for Health Data Science and Analytics, Houston Methodist Research Institute, Houston, TX., Division of Urology and Surgical Oncology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Urology, University of Toronto, Toronto, Ontario, Canada; Division of Urology, Mount Sinai Hospital, Toronto, Ontario, Canada., Department of Urology, Houston Methodist Hospital, Houston, TX. Electronic address: .