Abstract
Purpose
To examine postoperative complications after radical cystectomy (RC) and creation
of an ileum conduit (IC) or a neobladder (NB), and to identify preoperative risk factors
in a contemporary series of bladder cancer patients.
Patients and Methods
The study relied on prospectively collected data for 842 patients, who underwent inpatient
rehabilitation (IR) after RC and urinary diversion (IC n = 447, NB n = 395) between
April 2018 and December 2019. Postoperative complications until the end of IR were
assessed according to the Clavien-Dindo classification. Uni- and multivariate analyses
were performed to identify predictors for complications.
Results
A total of 2689 complications occurred in 813 patients (96.6%). High-grade complications
occurred more frequently before IR onset (25.5% vs. 5.7%; P < .001), whereas a higher percentage of low-grade complications occurred during IR
(89.0% vs. 77.8%; P < .001). The most common complication categories were genitourinary (60.9%), infectious
(54.0%) and gastrointestinal (49.2%). Rates of high-grade complications do not differ
between IC and NB patients (26.8% vs. 31.6%, P = .126). Independent predictors for overall complications were NB (odds ratio [OR]
21.520; P < .001), age ≥70 years (OR 2.522; P = .027) and higher body mass index (OR 1.153, P = .008). Risk factors for high-grade complications were NB (OR 1.448; P = .039) and Charlson Comorbidity Index ≥2 (OR 1.999; P = .001). Hospital readmission rate was 9.4%.
Conclusion
Our study revealed significantly higher overall and high-grade complication rates
after RC with IC or NB creation than previously published. A high percentage of low-grade
complications occur after hospital discharge. The hospital readmission rate was lower
compared to historical data.
Keywords
Abbreviations:
RC (radical cystectomy), IC (ileum conduit), NB (neobladder), IR (inpatient rehabilitation), CDC (Clavien-Dindo classification), CCI (Charlson Comorbidity Index), BMI (body mass index), IQR (interquartile range), CI (confidence interval), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 19, 2022
Accepted:
May 17,
2022
Received in revised form:
May 12,
2022
Received:
December 2,
2021
Identification
Copyright
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