Perioperative outcomes of intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy in multicenter KORARC database

@article{yuk2026perioperative,
  title = {{Perioperative outcomes of intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy in multicenter KORARC database}},
  author = {Hyeong Dong Yuk and Jang Hee Han and Seung-Hwan Jeong and Chang Wook Jeong and Cheol Kwak and Jong Jin Oh and Tae Gyun Kwon and Tae-Hwan Kim and Seung Hyun Jeon and Sang Hyup Lee and Jong Kil Nam and Wan Seok Kim and Byong Chang Jeong and Ji Youl Lee and Sung Hoo Hong and Woong Kyu Han and Won Sik Ham and Young Goo Lee and Yong Seong Lee and Sung Yul Park and Young Eun Yoon and Sung Gu Kang and Seok Ho Kang and Ja Hyeon Ku and Korean Robot Assisted Radical Cystectomy (KORARC) Study Group},
  journal = {World Journal of Urology},
  year = {2026},
  month = oct,
  doi = {10.1007/s00345-026-06550-7},
  url = {https://doi.org/10.1007/s00345-026-06550-7},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Perioperative outcomes of intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy in multicenter KORARC database
AU  - Hyeong Dong Yuk
AU  - Jang Hee Han
AU  - Seung-Hwan Jeong
AU  - Chang Wook Jeong
AU  - Cheol Kwak
AU  - Jong Jin Oh
AU  - Tae Gyun Kwon
AU  - Tae-Hwan Kim
AU  - Seung Hyun Jeon
AU  - Sang Hyup Lee
AU  - Jong Kil Nam
AU  - Wan Seok Kim
AU  - Byong Chang Jeong
AU  - Ji Youl Lee
AU  - Sung Hoo Hong
AU  - Woong Kyu Han
AU  - Won Sik Ham
AU  - Young Goo Lee
AU  - Yong Seong Lee
AU  - Sung Yul Park
AU  - Young Eun Yoon
AU  - Sung Gu Kang
AU  - Seok Ho Kang
AU  - Ja Hyeon Ku
AU  - Korean Robot Assisted Radical Cystectomy (KORARC) Study Group
PY  - 2026
DA  - 2026/10/27
JO  - World Journal of Urology
DO  - 10.1007/s00345-026-06550-7
UR  - https://doi.org/10.1007/s00345-026-06550-7
AB  - Purpose: To compare perioperative outcomes of intracorporeal (ICUD) versus extracorporeal urinary diversion (ECUD) following robot-assisted radical cystectomy (RARC) in localized bladder cancer, using the Korean RARC (KORARC) Study Group database.  Methods: Patient characteristics, intraoperative details, and perioperative outcomes were compared between ICUD and ECUD groups. The primary outcome was postoperative complications; secondary outcomes were operative time, hospital stay, estimated blood loss (EBL), and transfusion rate. Multivariate regression adjusted for potential confounders, and subgroup analyses stratified by urinary diversion type were performed.  Results: Of 703 patients undergoing RARC between 2007 and 2019, 26.5% had ICUD and 73.5% had ECUD. Overall complication rates were similar (52.7% vs. 60.0%, p = 0.101), but ICUD showed fewer late complications (30–90 days; 30.1% vs. 38.9%, p = 0.041) and longer operative time (494.6 ± 120.6 vs. 417.9 ± 136.6 min, p < 0.001). On multivariate analysis, ICUD was independently associated with reduced late complications (Odds ratio [OR] 0.68, 95% confidence interval [CI]: 0.47–0.97, p = 0.034), without affecting minor, major, or overall complication risks. In diversion-stratified analyses, ICUD required longer operative time in both ileal conduit (514.6 vs. 453.8 min, p < 0.001) and neobladder (470.6 vs. 405.6 min, p < 0.001) subgroups. EBL was higher with ICUD in the ileal conduit subgroup (p = 0.034) but lower in the neobladder subgroup (p = 0.003). The protective effect on late complications was confined to the ileal conduit subgroup (adjusted OR 0.60, 95% CI 0.38–0.95, p = 0.029) and not observed in the neobladder subgroup (OR 0.76, p = 0.462).  Conclusion: Although associated with longer operative time, ICUD may reduce late postoperative complications compared with ECUD without compromising perioperative safety or oncological outcomes after RARC.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00345-026-06550-7.
SN  - 0724-4983
SN  - 1433-8726
ER  -