Robotic Bladder Surgery Fails to Cut Complications
By HospiMedica International staff writers Posted on 06 Aug 2014 |
Robot-assisted and open cystectomy led to similar complication rates among patients with invasive bladder cancer, according to a new study.
Researchers at Memorial Sloan Kettering Cancer Center (MSKCC; New York, NY, USA) conducted a prospective, randomized clinical trial to compare open and robot-assisted laparoscopic cystectomy in 118 patients with newly diagnosed invasive bladder cancer. All surgeries were performed by the same seven surgeons, four experienced in open technique and three with extensive background in robot-assisted cystectomy. The primary outcome was complication rate during the first 90 days after surgery, as defined in accordance with the Clavien grading system.
During the study, 58 patients were randomized to open cystectomy and 60 to robot-assisted laparoscopic cystectomy. Subsequently, four patients in the robotics group refused randomized treatment and underwent open cystectomy. The results showed that 90-day complication rate was 62% with robotic surgery and 66% with open surgical resection of the bladder, with a similar proportion of severe complications. Enrollment stopped when an interim analysis showed that outcomes at that point met predefined criteria for futility. The study was published in the July 24, 2014, issue of the New England Journal of Medicine (NEJM).
“Because the trial was performed by experienced surgeons at a single, high-volume referral center, the results may not be generalizable to all clinical settings,” concluded lead author Bernard Bochner, MD, and colleagues. “Nonetheless, these results highlight the need for randomized trials to inform the benefits and risks of new surgical technologies before widespread implementation.”
Radical cystectomy remains standard of care for non-metastatic, invasive bladder cancer. However, the procedure often leads to clinically significant perioperative complications, exacerbated by older age, comorbidities, and other patient characteristics. Not uncommonly, patients require an extended recovery period.
Related Links:
Memorial Sloan Kettering Cancer Center
Researchers at Memorial Sloan Kettering Cancer Center (MSKCC; New York, NY, USA) conducted a prospective, randomized clinical trial to compare open and robot-assisted laparoscopic cystectomy in 118 patients with newly diagnosed invasive bladder cancer. All surgeries were performed by the same seven surgeons, four experienced in open technique and three with extensive background in robot-assisted cystectomy. The primary outcome was complication rate during the first 90 days after surgery, as defined in accordance with the Clavien grading system.
During the study, 58 patients were randomized to open cystectomy and 60 to robot-assisted laparoscopic cystectomy. Subsequently, four patients in the robotics group refused randomized treatment and underwent open cystectomy. The results showed that 90-day complication rate was 62% with robotic surgery and 66% with open surgical resection of the bladder, with a similar proportion of severe complications. Enrollment stopped when an interim analysis showed that outcomes at that point met predefined criteria for futility. The study was published in the July 24, 2014, issue of the New England Journal of Medicine (NEJM).
“Because the trial was performed by experienced surgeons at a single, high-volume referral center, the results may not be generalizable to all clinical settings,” concluded lead author Bernard Bochner, MD, and colleagues. “Nonetheless, these results highlight the need for randomized trials to inform the benefits and risks of new surgical technologies before widespread implementation.”
Radical cystectomy remains standard of care for non-metastatic, invasive bladder cancer. However, the procedure often leads to clinically significant perioperative complications, exacerbated by older age, comorbidities, and other patient characteristics. Not uncommonly, patients require an extended recovery period.
Related Links:
Memorial Sloan Kettering Cancer Center
Latest Surgical Techniques News
- Novel Rigid Endoscope System Enables Deep Tissue Imaging During Surgery
- Robotic Nerve ‘Cuffs’ Could Treat Various Neurological Conditions
- Flexible Microdisplay Visualizes Brain Activity in Real-Time To Guide Neurosurgeons
- Next-Gen Computer Assisted Vacuum Thrombectomy Technology Rapidly Removes Blood Clots
- Hydrogel-Based Miniaturized Electric Generators to Power Biomedical Devices
- Custom 3D-Printed Orthopedic Implants Transform Joint Replacement Surgery
- Wearable Technology Monitors and Analyzes Surgeons' Posture during Long Surgical Procedures
- Cutting-Edge Imaging Platform Detects Residual Breast Cancer Missed During Lumpectomy Surgery
- Computational Models Predict Heart Valve Leakage in Children
- Breakthrough Device Enables Clear and Real-Time Visual Guidance for Effective Cardiovascular Interventions
- World’s First Microscopic Probe to Revolutionize Early Cancer Diagnosis
- World’s Smallest Implantable Brain Stimulator Demonstrated in Human Patient
- Robotically Assisted Lung Transplants Could Soon Become a Reality
- AI to Provide Heart Transplant Surgeons with New Decision-Making Data
- New Surgical Tool Empowers Precision and Confidence in Operating Room
- Future Muscle-Powered Surgical Robots Could Perform Minimally Invasive Procedures inside Body