EARLY POSTOPERATIVE COMPLICATIONS AFTER RADICAL CYSTECTOMY WITH ORTHOTOPIC BLADDER SUBSTITUTION

Česká verzia

Authors: David Míka ^1,2; Ondřej Havránek ^1,2; David Němec ^1,2; Radek Sýkora ^1,2; Libor Luňáček ^1,2; Jan Krhut ^1,2
Authors place of work: Urologické oddělení FN Ostrava ¹; Katedra chirurgických oborů Ostravské univerzity Ostrava ²
Published in the journal: Ces Urol 2016; 20(2): 148-153
Category: Original Articles

Summary

Aim:
The use of standardized methods assessing perioperative complications after a radical cystectomy is necessary for objective evaluation of the morbidity associated with surgery. The Clavien- Dindo classification is nowadays widely used to assess the degree of complications.

Material and method:
We evaluated retrospectively a set of 18 consecutive patients, who underwent radical cystectomy with orthotopic bladder Mansoura pouch substitution between 2010 and 2012. We classified the early postoperative complications within 30 and 90 days after surgery using Clavien-Dindo system.

Results:
Average age of patients included in the study was 56.6 years (31–70). All patients underwent an orthotopic antireflux urinary diversion usually called Mansoura pouch. The average length of hospitalization was 25.8 days (17–60). Within 30 days after surgery, we identified 5 patients with complications of the Clavien type I, 8 patients with complications of Clavien type II, 1 patient with Clavien type IIIa, 3 patients with Clavien type IIIb, and 1 patient as Clavien type IVb. Within the 90-day evaluation 12 patients were classified as Clavien type I, 3 patients as Clavien type II, 2 patients as Clavien type IIIb, and 1 patient as Clavien type V.

Conclusions:
Radical cystectomy is currently the only curative treatment modality of muscleinvasive bladder cancer. Significant morbidity and mortality is in relation to the technical complexity of this kind of surgery, especially in the case of orthotopic diversion. Exact standardized classification of the possible complications allows comparison of results of individual departments and their individual techniques.

Key words:
Clavien-Dindo system, urinary bladder cancer,”- Mansoura pouch”, orthotopic substitution of the urinary bladder, radical cystectomy.

Zdroje

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