Morbidity and mortality after open radical cystectomy and ileal diversion - 10 years experience and a comprehensive assessment in a single tertiary center

Kód výsledku v IS VaVaI

RIV/00216208:11130/21:10427723 - isvavai.cz

Nalezeny alternativní kódy

RIV/00064203:_____/21:10427723

Výsledek na webu

https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=BUXyTNHbbV

DOI - Digital Object Identifier

10.4149/neo_2021_210202N161

Jazyk výsledku

angličtina

Název v původním jazyce

Morbidity and mortality after open radical cystectomy and ileal diversion - 10 years experience and a comprehensive assessment in a single tertiary center

Popis výsledku v původním jazyce

Open radical cystectomy (ORC) remains the gold standard for the treatment of muscle-invasive and high-risk non-muscle invasive bladder cancer unsuitable for bladder preservation techniques. Despite improvements in operative technique and perioperative care, it continues to be associated with significant complications. We analyzed our series of prospectively collected data of patients that underwent ORC at a tertiary referral academic center and evaluated early and late postoperative complications and mortality. The records of 391 ORCs with ileal diversion performed at our institution between January 2008 and July 2018 for non-metastatic transitional bladder carcinoma and other distinct pathological types were analyzed. Perioperative mortality was determined and 30-day and 90-day complications were reported according to the Martin Criteria and the European Association of Urology and graded according to the five-grade Clavien-Dindo classification. Univariate and multivariate analyses were used to evaluate predictors of complications and mortality. Gastrointestinal and infectious complications represented 41% and 43% of the total complications observed at 30 and 90 days from the surgery, respectively. The strongest predictor of infectious complications was the choice of ileal neobladder as the urinary diversion (p <= 0.0001). Diabetes was a predictor of the overall, major and major infectious complications (p < 0.05). The 30-day mortality rate was 1% while the 90-day mortality rate was 1.5%. Age >= 75 was the single predictor of mortality at both 30-days (p-value 0.003) and 90-days (p-value 0.01) in univariate and multivariate analyses. ORC is a morbid procedure, associated with a high mortality rate. Elderly patients should have proper counseling before indication of this procedure. Gastrointestinal and infectious complications represent the most common and serious complications, and the study of their predictors is of the utmost importance.

Název v anglickém jazyce

Morbidity and mortality after open radical cystectomy and ileal diversion - 10 years experience and a comprehensive assessment in a single tertiary center

Popis výsledku anglicky

Open radical cystectomy (ORC) remains the gold standard for the treatment of muscle-invasive and high-risk non-muscle invasive bladder cancer unsuitable for bladder preservation techniques. Despite improvements in operative technique and perioperative care, it continues to be associated with significant complications. We analyzed our series of prospectively collected data of patients that underwent ORC at a tertiary referral academic center and evaluated early and late postoperative complications and mortality. The records of 391 ORCs with ileal diversion performed at our institution between January 2008 and July 2018 for non-metastatic transitional bladder carcinoma and other distinct pathological types were analyzed. Perioperative mortality was determined and 30-day and 90-day complications were reported according to the Martin Criteria and the European Association of Urology and graded according to the five-grade Clavien-Dindo classification. Univariate and multivariate analyses were used to evaluate predictors of complications and mortality. Gastrointestinal and infectious complications represented 41% and 43% of the total complications observed at 30 and 90 days from the surgery, respectively. The strongest predictor of infectious complications was the choice of ileal neobladder as the urinary diversion (p <= 0.0001). Diabetes was a predictor of the overall, major and major infectious complications (p < 0.05). The 30-day mortality rate was 1% while the 90-day mortality rate was 1.5%. Age >= 75 was the single predictor of mortality at both 30-days (p-value 0.003) and 90-days (p-value 0.01) in univariate and multivariate analyses. ORC is a morbid procedure, associated with a high mortality rate. Elderly patients should have proper counseling before indication of this procedure. Gastrointestinal and infectious complications represent the most common and serious complications, and the study of their predictors is of the utmost importance.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

NV15-33910A: Laboratorní a klinické testování kandidátních onkomarkerů karcinomu prostaty s využitím komplexní kryobanky vzorků dlouhodobě sledovaných pacientů.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Neoplasma

ISSN

0028-2685

e-ISSN

—

Svazek periodika

68

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

SK - Slovenská republika

Počet stran výsledku

10

Strana od-do

882-891

Kód UT WoS článku

000678368100023

EID výsledku v databázi Scopus

2-s2.0-85114056155