The following is a summary of “Analysis of Complications After Robot-Assisted Radical Cystectomy Between 2002-2021,” published in the JANUARY 2023 issue of Urology by Houenstein, et al.

For a study, researchers sought to analyze the trends in postoperative complications after robot-assisted radical cystectomy (RARC) using a database from multiple institutions, the International Robotic Cystectomy Consortium (IRCC), which included 2,976 patients from 26 institutions across 11 countries. 

The postoperative complications were classified as overall or high-grade (≥ Clavien Dindo III) and grouped according to the type/organ site. The data were summarized using descriptive statistics, while multivariate analysis (MVA) was used to identify factors associated with high-grade and overall complications. The Cochran-Armitage trend test was used to examine the trend of complications over time.

The results showed that 1,777 patients (60%) developed postoperative complications after RARC, with 51% occurring within 30 days, 19% between 30-90 days, and 30% after 90 days. High-grade complications were observed in 835 patients (28%). Infectious complications (25%) were the most frequent while bleeding (1%) was the least. The incidence of complications remained steady between 2002-2021. However, gastrointestinal and neurologic complications increased significantly (P < .01, for both) between 2005 and 2020, while thromboembolic (P = .03) and wound complications (P < .01) decreased. In addition, MVA revealed that high-grade complications were associated with BMI (OR 1.03, 95%CI 1.01-1.05, P < .01), prior abdominal surgery (OR 1.26, 95%CI 1.03-1.56, P = .03), receipt of neobladder (OR 1.52, 95%CI 1.17-1.99, P < .01), positive nodal disease (OR 1.33, 95%CI 1.05-1.70, P = .02), length of inpatient stay (OR 1.04, 95%CI 1.02-1.05, P < .01), and ICU admission (OR 1.67, 95%CI 1.36-2.06, P < .01).

In conclusion, overall and high-grade complications after RARC remained stable between 2002-2021. Gastrointestinal and neurologic complications increased, while thromboembolic and wound complications decreased over time.

Reference: goldjournal.net/article/S0090-4295(22)00832-9/fulltext