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. 2013 Dec;112(8):1113-20.
doi: 10.1111/bju.12239. Epub 2013 Jul 26.

Risk of in-hospital complications after radical cystectomy for urinary bladder carcinoma: population-based follow-up study of 7608 patients

Mieke van Hemelrijck  1 , Andreas Thorstenson, Philip Smith, Jan Adolfsson, Olof Akre
Affiliations
Free PMC article

Risk of in-hospital complications after radical cystectomy for urinary bladder carcinoma: population-based follow-up study of 7608 patients

Mieke van Hemelrijck et al. BJU Int. 2013 Dec.
Free PMC article

Abstract

Objective: To evaluate the risk of different in-hospital complications for patients undergoing a radical cystectomy (RC), as limited nationwide population data on short- and long-term complications after RC is available, despite it being the standard treatment for localised muscle-invasive urinary bladder cancer (UBC).

Patients and methods: In all, 7608 persons underwent a RC after UBC diagnosis, as registered in the Swedish National Patient Register between 1964 and 2008. We estimated the frequency and incidences and calculated hazard ratios (HR) and 95% confidence intervals (CI) using multivariate Cox proportional hazards models.

Results: Urinary tract infection/septicaemia was the most common complication following radical cystectomy, with an incidence of 90.4 per 1,000 person years. There was a higher risk of urinary tract infection among patients who had a continent cutaneous reservoir (HR: 1.11 (0.94-1.30) or orthotopic neobladder 1.21 (1.05-1.39) than among those with ileal conduit. Similarly, continent cutaneous reservoir and orthotopic neobladder were associated with increased risks for wound and abdominal wall hernias, stones in the urinary tract, hydronephrosis and nephrostomy tube treatment, and kidney failure. In contrast, risk of bowel obstruction was lower among those with orthotopic neobladder than those with ileal conduit (HR: 0.64 (0.50-0.81)) and those with continent cutaneous reservoir (HR: 0.92 (0.73-1.16).

Conclusions: In-hospital complications after RC are numerous and continue to accumulate for many years after surgery, indicating the need for life-long follow-up of these patients. Comparison between different types of diversion should, however, be made with care because of potential confounding by indication.

Keywords: bladder cancer; complication; cystectomy.

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Figures

Figure 1
Figure 1
Cumulative incidence of different complications after different types of RC in Sweden, 1964–2008.
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References

    1. Stenzl A, Cowan NC, De Santis M, et al. [Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU Guidelines] Actas Urol Esp. 2012;36:449–460. - PubMed
    1. Maffezzini M, Campodonico F, Canepa G, Gerbi G, Parodi D. Current perioperative management of radical cystectomy with intestinal urinary reconstruction for muscle-invasive bladder cancer and reduction of the incidence of postoperative ileus. Surg Oncol. 2008;17:41–48. - PubMed
    1. Hautmann RE, de Petriconi RC, Volkmer BG. Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol. 2010;184:990–994. - PubMed
    1. Novara G, De Marco V, Aragona M, et al. Complications and mortality after radical cystectomy for bladder transitional cell cancer. J Urol. 2009;182:914–921. - PubMed
    1. Chang SS, Cookson MS, Baumgartner RG, Wells N, Smith JA., Jr Analysis of early complications after radical cystectomy: results of a collaborative care pathway. J Urol. 2002;167:2012–2016. - PubMed

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