Perioperative Outcomes of Open Retrograde Extraperitoneal Versus Intracorporeal Robot-assisted Radical Cystoprostatectomy in Men: A Dual-center Comparative Study.

Abstract Objective To compare Retrograde extra-peritoneal open Radical Cysto-prostatectomy (RRC) and Robot Assisted Radical Cysto-prostatectomy with intra-corporeal diversion (iRARC) and report early perioperative outcomes. Patients and methods Each technique was performed in a different tertiary high volume center in two different countries. Males ≥ 18 years with pre-cystectomy clinical T1 – T3 disease were included. Patients with prior major pelvic and/or intraabdominal surgeries, previous pelvic and/or abdominal irradiation, females and clinical T4 disease were excluded. All patients were managed according to a standardized Enhanced Recovery After Surgery (ERAS) protocol and all underwent ileal conduit urinary diversion. Bowel recovery was one of the main points of interest; time to passing flatus, tolerating oral feeding and bowel movement were determined. Operative time, estimated blood loss, intraoperative complications, length of hospital stay, post-cystectomy tumor type, stage, margin status, lymph node yield, 30 and 90-days complications were analyzed. Results A retrospective analysis of prospectively collected data between October 2016 and December 2018 showed that a total of 99 patients 50 underwent RRC and 49 iRARC. Demographics and preoperative parameters were comparable. RRC showed significant lower mean operative time (p Conclusion RRC has the equivalent advantages of quicker bowel recovery and shorter length of stay comparable to iRARC. It should be adopted as preferred open radical cysto-prostatectomy approach in institutions where a surgical robot is not available.