Is robot-assisted radical cystectomy the right way to reduce complications in patients undergoing radical cystectomy?

摘要

Perioperative complications are one of the most important short-term end points in the evaluation of any surgical procedure. Due to their relevance as a surgical outcome measure, complication reports in the medical literature need clarity, consistency, and standardization. In 2002, Martin et al, from Memorial Sloan-Kettering Cancer Center, reported a standardized method of reporting complications following surgery that was based on 10 criteria, including data accrual methods, follow-up duration, outpatient information, complication definitions, mortality and morbidity rates, procedure-specific complications, severity grading, hospital stay, and risk factor analysis [1]. The use of such standardization allows for reliable assessment of complications based on the logical assumption that the higher the methodological quality of the report, the lower the risk of underreporting complications. Moreover, such an accurate assessment is mandatory for comparing complications related to different competing procedures, such as open and minimally invasive surgery. Despite the relevance of such standardization, in 2007 Donat [2] concluded a nonsystematic review of the urological literature by stating that very few studies assessing the major urologic procedures fulfilled all of these criteria, although some good-quality reports were subsequently published, mainly evaluating radical prostatectomy [3-6].