Robot-assisted radical cystectomy followed by intracorporeal versus extracorporeal ileal conduit: a comparison of complications in a real-world setting
摘要
To evaluate the complication rates between robot-assisted radical cystectomy (RARC) with extracorporeal ileal conduit (ECIC) vs. intracorporeal ileal conduit (ICIC) in a real-world setting.
MethodsThis prospective study was carried out between May 2021 and December 2024 and all patients who were undergoing RARC with ileal conduit were included. The choice of urinary diversion was made on the surgeon’s preference and a modified ERAS protocol was followed in all the patients. For all the patients, the demographic profile, intra-operative and post-operative parameters and 30-day complications as per the Clavien-Dindo classification and the oncologic outcomes were recorded and compared between those who underwent ECIC and ICIC.
ResultsA total of 79 patients were included, 33 had ECIC and 46 had ICIC and the baseline characteristics were similar between the two groups. The time to intake of a soft diet was faster in the ICIC group, with 84.78% resuming it by POD 2 and length of hospital stay was also shorter. The low-grade complications (Clavien I-II) were significantly lower in the ICIC group (39.39% vs. 10.87%, p = 0.003), whereas the high-grade complications were similar in both the arms.
ConclusionICIC was associated with faster bowel recovery and fewer low‑grade complications in this non-randomized cohort. Due to learning‑curve and selection bias, these findings require validation in randomized or risk‑adjusted studies.