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KMID : 0358320150560010048
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Korean Journal of Urology
2015 Volume.56 No. 1 p.48 ~ p.55
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Standardized analysis of complications after robot-assisted radical cystectomy: Korea University Hospital experience
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Pyun Jong-Hyun
Kim Hyung-Keun
Kim Jae-Yoon
Kim Seung-Bin
Cho Seok
Kang Sung-Gu
Ko Young-Hwii
Cheon-Jun
Lee Jeong-Gu
Kim Je-Jong
Kang Seok-Ho
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Abstract
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Purpose: To analyze the complications after robot-assisted radical cystectomy (RARC) by use of a standardized reporting methodology by a single surgeon.
Materials and Methods: We prospectively reviewed a maintained institutional database of 52 patients who underwent RARC to manage bladder cancer and were followed up in 3 months by a single surgeon at Korea University Medical Center from 2007 through 2014. All complications within 90 days of surgery were defined and categorized into 5 grades according to the Clavien-Dindo classification. Logistic regression analysis was used to identify predictors of complications.
Results: Fifty percent of patients (26 of 52) experienced a complication of any grade <90 days after surgery, and 11 patients (21.2%) experienced a major complication. Complications were grouped in systems-based categories. Fifty complications occurred in 52 patients and hematologic complication (transfusion) was the most common (13 of 52). Wound dehiscence, anastomotic leakage, urinary tract obstruction, mechanical obstruction, and thromboembolism occurred as major complications. Mean estimated blood loss (EBL) was 247 mL and mean total operative time was 496 minutes. The mean number of lymph nodes harvested was 24.6, with 30.5 for extended dissection. EBL (over 300 mL), operative time, and method of urinary diversion were significant negative predictors of minor complications, whereas EBL (over 300 mL) was a significant negative predictor of major complications (p<0.05).
Conclusions: The present results show that the complication rate reported by use of a standardized methodology after robotic radical cystectomy is still considerable although comparable to that of contemporary robot series. EBL, operative time, and diversion methods were predictors of complications.
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KEYWORD
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Cystectomy, Postoperative complication, Robotics, Urinary diversion
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