The morbidity of laparoscopic radical cystectomy: analysis of postoperative complications in a multicenter cohort by the European Association of Urology ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-02

AUTHORS

Simone Albisinni, Marco Oderda, Laurent Fossion, Virginia Varca, Jens Rassweiler, Xavier Cathelineau, Piotr Chlosta, Alexandre De la Taille, Franco Gaboardi, Thierry Piechaud, Peter Rimington, Laurent Salomon, Rafael Sanchez-Salas, Jens-Uwe Stolzenburg, Dogu Teber, Roland Van Velthoven

ABSTRACT

PURPOSE: To analyze postoperative complications after laparoscopic radical cystectomy (LRC) and evaluate its risk factors in a large prospective cohort built by the ESUT across European centers involved in minimally invasive urology in the last decade. METHODS: Patients were prospectively enrolled, and data were retrospectively analyzed. Only oncologic cases were included. There were no formal contraindications for LRC: Also patients with locally advanced tumors (pT4a), serious comorbidities, and previous major abdominal surgery were enrolled. All procedures were performed via a standard laparoscopic approach, with no robotic assistance. Early and late postoperative complications were graded according to the modified Clavien-Dindo classification. Multivariate logistic regression was performed to explore possible risk factors for developing complications. RESULTS: A total of 548 patients were available for final analysis, of which 258 (47%) experienced early complications during the first 90 days after LRC. Infectious, gastrointestinal, and genitourinary were, respectively, the most frequent systems involved. Postoperative ileus occurred in 51/548 (9.3%) patients. A total of 65/548 (12%) patients underwent surgical re-operation, and 10/548 (2%) patients died in the early postoperative period. Increased BMI (p = 0.024), blood loss (p = 0.021), and neoadjuvant treatment (p = 0.016) were significantly associated with a greater overall risk of experiencing complications on multivariate logistic regression. Long-term complications were documented in 64/548 (12%), and involved mainly stenosis of the uretero-ileal anastomosis or incisional hernias. CONCLUSIONS: In this multicenter, prospective, large database, LRC appears to be a safe but morbid procedure. Standardized complication reporting should be encouraged to evaluate objectively a surgical procedure and permit comparison across studies. More... »

PAGES

149-156

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-015-1633-1

DOI

http://dx.doi.org/10.1007/s00345-015-1633-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1037638674

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26135307


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