Bladder Cancer: Robotic Surgery is as Effective as Traditional Surgery

When robotic and traditional surgery of bladder cancer were compared, it was found that both these methods were equally effective and no major risk to the patients was found after the surgery.

Highlights

Robotic surgery has been found to be as effective as open surgery for bladder cancer removal
No significant risks to patient’s survival were found after both the surgeries
Less amount of blood loss was an advantage in case of robotic surgeries

Robotic surgery for Bladder cancer is as effective as traditional surgery method, finds a new study. The findings of this study are published in the Lancet journal .

Three urologists from the Loyola Medicine - Dr.Marcus Quek, Dr.Gopal Gupta, Dr. Alex Gorbonos have coauthored this study. Dr. Dipen Parekh from of the University of Miami is the first author of this study.

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‘Robotic surgery was found to have less blood loss risk and shorter hospital stays but was associated with longer surgery time’

Loyola was among 15 centers that had participated in the nationwide trial of 350 patients who were randomly assigned to undergo robotic surgery and open surgery for bladder cancer.

No significant differences were found in the patients who had undergone the robotic procedure and those who had undergone the traditional surgery after the first two years.

Robotic surgery patients lost less amount of blood compared to the other patient who had undergone the normal procedure. Duration of hospital stay was less but longer surgery time.

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The National Cancer Institute funded this RAZOR (randomized open versus robotic cystectomy trial) study. No significant differences were found in complication rates or patient’s quality of life after the study.

The robotic system of surgery lets the surgeons have the upper hand by letting them do the operations through small and accurate incisions. The movements are directly copied by the robot which performs those incisions in a highly precise manner with surgical instruments. The surgeon also gets a 3D, high-definition view of the surgical area.

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Ever since it was introduced in the year 2000, it has been used to perform four million surgeries worldwide. But apart from the RAZOR trial, there have been no major study Comparisons between the two methods with regard to cancer survival.

Nearly 72.3 percent of patients in the RAZOR trial who had undergone robotic surgery were alive without any indication of disease progression compared to the other 71.6 percent.

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Sixty-seven percent of the robotic surgery patients had slight adverse effects such as urinary tract infections and intestinal obstructions, compared to 69 percent of the open surgery group.

Patients who had traditional surgery stayed a day late in the hospital before they were discharged from the hospital compared to robotic surgery patients.

"It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate)," said Dr. Gupta.

Reference
1.Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomized, phase 3, non-inferiority trial. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30996-6/fulltext

Source-Eurekalert