Category: Clinical Oncology: Outcomes & Complications

MP30-10 - Comparison of Perioperative and Oncological Outcomes of Robotic vs Open Partial Cystectomy: A Single Centre Experience

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

To report on patients undergoing partial cystectomy (PC) using robotic vs open approach, focusing on perioperative outcomes over a range of clinical and pathological variables, as well as the oncological efficacy of both approaches.


Methods :

We retrospectively reviewed all patients who underwent partial cystectomy at our institution between 2008 and 2018. Clinicopathological data and perioperative variables were recorder. Continuous variables were compared using the Student’s t-test.  Overall survival was estimated using the Kaplan-Meier method (Figure 1).


Results :

At our institution, we identified 23 patients who underwent PC for definitive management of a primary disease. Data of demographics and clinical characteristics are reported in Table 1.  Operative time was longer in the robotic group, 169 (143-226) minutes, than the open group, 121 (99-176) minutes (p=0.05). There was no difference in median estimated blood loss (p=0.77). No patient required transfusion. There were two postoperative complications (Clavien IIIb and I for the robotic and open approach, respectively). Median follow-up was 13.6 (IQR 9.4, 64.6) months for the robotic partial cystectomy group and 35.7 (IQR 29.4, 76.4) months for the open partial cystectomy group. There were none positive surgical margin on the cohort.  


Conclusions :

According to our institutional experience, the robotic partial cystectomy is safe and reproducible approach conferring similar outcomes that the open approach. Oncological efficacy is comparable between the groups and may represent an optimal surgical approach for organ-preserving bladder surgery. Further studies with a larger sample size are needed to confirm these results.

Juan Garisto

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Juan Garisto, MD is an Advanced Laparoscopy & Robotics clinical fellow at Cleveland Clinic, Cleveland, OH, United States under the mentorship of Dr. Jihad Kaouk. He completed a Society of Urologic Oncology fellowship at the University of Toronto and did his urology residency training at Complejo Hospitalario Dr. A.A.Madrid in Panama City, Panama.

His current research interest in single port surgery and multidisciplinary management of urologic malignancies, in particular kidney and bladder cancer.

Sherif Armanyous

MD
Cleveland Clinic Foundation
Cleveland, Ohio

Riccardo Bertolo

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Turin, Piemonte, Italy

Riccardo Bertolo, MD
Research Fellow, Robotic Urology,
Cleveland Clinic, Cleveland, OH, USA
PhD Candidate, Bioengineering in Medical/Surgical Sciences
Turin Politechnic, Italy

Julien Dagenais

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Daniel Sagalovich

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Jose Agudelo

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Robert Stein

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Amr Fergany

MD
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Jihad Kaouk

Professor and Director, Center for Robotic and Image Guided Surgery Vice Chair, Surgical Innovations
Glickman Urologic Institute, Cleveland Clinic
Cleveland, Ohio

Jihad Kaouk, MD FACS

Dr. Jihad Kaouk is an American Board certified Urologist and Director, Center of Robotic and Image Guided Surgery at the Cleveland Clinic Glickman Urological Institute. He also serves as Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Vice Chair for Surgical Innovations and chair holder for the Zegarac-Pollock Endowed Chair in laparoscopic and robotic surgery.
In Innovations, he has performed several first ever done surgical procedures, including the first Robotic single port surgery through the belly button in 2008, the first completely transvaginal kidney removal in 2009, and the first robotic perineal prostatectomy in 2014 Dr. Kaouk holds 2 USA patents for medical devices used during partial nephrectomy and in robotic surgery.

Since 2005, Dr. Kaouk has served on committees at the national and local levels. From 2005-2008, he served in the American Urological Association’s Urologic Diagnostic and Therapeutic Imaging Task Force, from 2006-2010 he was on the Guidelines for the Management of small Renal Masses committee. Currently Dr Kaouk serves as Chairman elect on the AUA New Technology and Imaging committee, and is President Elect of (SURS) Society of Urologic Robotic Surgery. Dr Kaouk is associate editor of Urology journal.

Dr Kaouk have lectured in 130 scientific meetings, chaired 24 urologic meeting and performed live surgery in 18 medical centers worldwide. He authored 460 peer reviewed scientific publication, 26 book chapters and hundreds of scientific abstracts and surgical movies. Dr Kaouk received 32 honors and awards including Cleveland clinic innovator award twice, Teacher of the Year award, and EndoUrology 2017 Best Fellowship Program Director Award.

Presently, Dr Kaouk holds membership with the American Urological Association, the Endourological Society, Society of Urologic Oncology, Society of Robotic Surgery, and the Lebanese Order of Physicians. He is a fellow of the American college of Surgeons.