Outcomes and complications of radical cystectomy with ileal conduit urinary diversion: A comparison between open, semi-robotic and totally robotic surgery.

Background: It was aimed to compare open versus robotic-assisted radical cystectomy (RARC) with intracorporeal ileal conduit (ICIC), versus RARC with extracorporeal ileal conduit (ECIC) formation for bladder cancer.

Methods: Open, RARC-ECIC and RARC-ICIC groups were compared in terms of patient demographics, operative and postoperative parameters, pathological parameters, complications and functional outcomes.

Results: Mean operative times were lower in the RARC-ECIC group (p = 0.004). Mean estimated blood loss was significantly lower (p < 0.01) in the robotic groups. The blood transfusion was lower in RARC-ICIC groups (p < 0.001). Rates of stage pT3-4 disease were the highest in the RARC-ICIC group (p = 0.004). LOS was significantly shorter in the RARC-ICIC group (p = 0.01). Numbers of Clavien 3-5 complications were lower in the robotic groups (p = 0.012).

Conclusions: RARC and ICIC is a complex procedure involving an increased operation time but with the advantages of lower estimated blood loss, transfusion rates, complications and hospital stays compared with open surgery.