Is robot-assisted radical cystectomy better for patient recovery than open surgery?

USA: In a new study conducted by Vivek Venkatramani and team, it was found that after radical cystectomy, patients take 3 to 6 months to return to baseline levels, regardless of surgical method. The findings of this study were published in the Journal of American Medical Association.

After radical cystectomy, no data on time to recovery of patient-reported and performance-related markers of functional independence available (open or robotic). As a result, the goal of this study was to see if functional independence could be restored following radical cystectomy and if robot-assisted radical cystectomy (RARC) has any advantages over open procedures.

The RAZOR (Randomized Open vs Robotic Cystectomy) experiment provided the data for this secondary analysis. RAZOR was a phase 3 multicenter noninferiority study that ran from July 1, 2011, to November 18, 2014, at 15 academic medical institutions across the United States, with a median follow-up of two years. The per-protocol population (n = 302) was among the participants.

From February 1, 2017, through May 1, 2021, data was evaluated. The subjects had robotic-assisted radical cystectomy (RARC) or open radical cystectomy (ORC). The measures of independence were patient-reported (activities of daily living [ADL] and independent ADL [iADL]) and performance-related (handgrip strength [HGS] and Timed Up & Go walking test [TUGWT]). Postoperative recovery Patterns for the entire cohort were studied, as well as comparisons between RARC and ORC. Exploratory analyses were conducted to evaluate measures of independence among diversion types and to see if baseline deficits were linked to 90-day complications or 1-year mortality.