Vanni AJ, Stoffel JT. Ileovesicostomy for the neurogenic bladder patient: outcome and cost comparison of open and robotic assisted techniques.
Urology 2010;
77:1375-80. [PMID:
21146864 DOI:
10.1016/j.urology.2010.09.021]
[Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 08/30/2010] [Accepted: 09/03/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVES
To compare the outcomes and cost of open and robotic-assisted ileovesicostomy techniques for the adult neurogenic bladder patient.
METHODS
Consecutive open and robotic-assisted ileovesicostomy procedures were retrospectively reviewed for demographic, operative, and postoperative recovery data. Surgical outcome was assessed by examining the incidence of postprocedure urinary incontinence, urinary tract infections (UTIs), and upper tract compromise. Total cost was calculated through summation of inpatient costs, including room/board, operating/recovery room, surgical supplies, professional fees, intensive care unit, and robotic maintenance.
RESULTS
Fifteen ileovesicostomy procedures (7 open, 8 robotic) were reviewed. Both groups had similar demographic and urodynamic data. Operative times (293 min open vs 330 min robotic, P = .24) were similar between techniques. There were trends toward lower operative blood loss (100 mL vs 257 mL, P = .09) and shorter hospital stays in the robotic group (8 days vs 11 days, P = .14). Ileovesicostomy was associated with improved urinary continence (P = .02) and trended toward a decreased incidence of postoperative chronic UTI (P = .13) for the entire group, and there was no difference between techniques regarding continence, chronic UTIs, and complications. No patients in either group developed postoperative hydronephrosis. Total inpatient cost for the open and robotic groups was $14,356 and $17,344 (P = .05), which differed primarily because of higher robotic operating room supply costs ($609 vs $3770, P <.001).
CONCLUSION
Robotic and open ileovesicostomy had similar surgical outcomes in this patient cohort, although total inpatient costs were significantly higher in the robotic group.
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