Téma: 

Perioperative complications of radical cystectomy in a contemporary series

Vladimír Novotný, Ulrike Heberling, Oliver W. Hakenberg, Manfred P. Wirth

Objective: Radical cystectomy is the preferred standard treatment for patients with muscle-invasive bladder cancer. With improvements in intra- and perioperative care lower complication rates have been reported. We retrospectively evaluated our series of patients who underwent radical cystectomy for advanced bladder cancer for perioperative complications. The operative time, postoperative hospital stay and transfusion rate were analysed as well.
Material and Methods: Between April 1993 and August 2005, 516 radical cystectomies were performed for muscle infiltrating transitional cell carcinoma and other types of neoplastic disease at our institution. The average age was 67 years (31 - 89 years).
Results: The perioperative mortality rate was 0,8 %. A total of 141 patients (27,3 %), developed at least one perioperative complication. The most frequent medical complications were: subileus in 20 (3,9 %) cases, deep venous thrombosis in 24 (4,7 %) cases and enterocolitis in 10 (1,9 %) cases. Surgical complications included pelvic lymphoceles in 42 (8,1 %) cases, wound dehiscence in 46 (8,9 %), pelvic hematoma in 4 (0,8 %), peritonitis in 4 (0,8 %) and small bowel obstruction in 4 cases (0,8 %). The total early reoperation rate was 6,2 %. Operative time, postoperative hospital stay and average number of blood units transfused decreased over the period 1993 - 2005.
Conclusions: Radical cystectomy today is a safe procedure with an acceptable rate of perioperative morbidity and mortality. Due to improvements in surgical technique, increased quality of perioperative care and adapted anesthesia in the last years have resulted in reduced morbidity and shorter hospital stay.

Ročník 2006  Témy časopisu Clinical urology 1 / 2006

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