Advantages of enhanced recovery after surgery program in robot-assisted radical cystectomy.

Radical cystectomy is a gold-standard treatment for muscle-invasive bladder cancer. We recently introduced robot-assisted radical cystectomy (RARC) with perioperative enhanced recovery after surgery (ERAS). The medical records of patients with bladder cancer who underwent open radical cystectomy (ORC) or RARC/ERAS at NTT Medical Center Tokyo were retrospectively reviewed to compare the surgical outcomes, hospital stay, and medical costs between groups. Multidisciplinary full ERAS items were provided for the RARC/ERAS group. The median estimated blood losses in the ORC and RARC/ERAS groups were 650 and 100 mL, and the median operative times were 312 and 445 min, respectively. In addition, the median times to liquid food intake in these groups were 6 and 0 days, the median times to first flatus and first defecation were 2 and 1 day, and 3 and 1.5 days, respectively. The rates of postoperative ileus in the ORC and RARC/ERAS groups were 27.5% and 4.5%, and the median postoperative hospital stays was 26.5 and 12 days, respectively. Medical costs excluding surgery were significantly lower in the RARC/ERAS group. In conclusion, RARC/ERAS represents a safe treatment option for muscle-invasive bladder cancer with decreased perioperative complications and lower medical costs.

Trends in surgical treatment for prostate cancer: Analysis of National Database Open Data in Japan.

We conducted a study to clarify the trends in surgical treatments for prostate cancer in Japan between 2014 and 2020 by analyzing the National Database (NDB) Open Data in Japan. Intriguingly, the number of patients over 70 years old who underwent robotic-assisted radical prostatectomy (RARP) nearly doubled from 2015 to 2019, while that in those 69 years old and younger remained almost constant during the same period. The increase in the number of patients over 70 years of age may reflect the fact that RARP can be safely applied to elderly patients. With the new development and spread of surgery-assisting robots, we can foresee a further increase in the number of RARPs performed for elderly patients in the future.