Complications within 90 days after radical cystectomy for bladder cancer: results of a multicenter prospective study in Japan

Abstract

Open radical cystectomy is associated with a high incidence of postoperative complications. Most, however, are of low grade. Our results suggest that obesity, a smoking history, and increasing comorbidity are risk factors for major complications.

Impact of Smoking Habit on Perioperative Morbidity in Patients Treated with Radical Cystectomy for Urothelial Bladder Cancer: A Systematic Review and Meta-analysis

“…Of note, only two studies partially reported smoking exposure in current smokers [37,44]. Finally, smoking status of patients was not reported in five studies [13,[45][46][47][48]. Surgical approach for RC was open in seven studies, robotic in six studies, and multiple (robotic, laparoscopic, or open) in four studies; finally, surgical approach was not reported/specified in 10 series.…”

“…In these studies, complication rates ranged from 31.7% to 80.5%. This high variability between studies depends mostly on discrepancy in reporting complications (ie, urinary or bowel-anastomotic complications only; overall, medical, and surgical complications), timing of recorded onset of complications (ie, 30 or 90 postoperative days after surgery), urinary diversion (UD) type, and adopted surgical approach (open vs laparoscopic vs robotic) [13,[35][36][37]39,41,[44][45][46][47][48].…”

“…The impact of smoking status on major postoperative complications after RC was assessed in 10 studies [13,14,24,34,35,[44][45][46][47][48], and six studies met the inclusion criteria for quantitative analysis. Postoperative complications were graded according to CDC [50] in seven studies, Memorial Sloan-Kettering Cancer Center (MSKCC) system [51] in two studies, and both CDC and MSKCC systems in one study.…”

“…Postoperative complications were graded according to CDC [50] in seven studies, Memorial Sloan-Kettering Cancer Center (MSKCC) system [51] in two studies, and both CDC and MSKCC systems in one study. Smoking status was determined according to patients' self-reporting in five studies [13,44,46,[45][46][47][48], while it was obtained from medical charts in one study [14]. The rate of major postoperative complications in the included studies ranged from 10.2% to 32%.…”

The role of cystoprostatectomy in management of locally advanced prostate cancer: a systematic review

“…Among patients after radical cystectomy for treating bladder cancer, general postoperative complications consist of cardiac, cerebral, pulmonary, vascular and gastrointestinal complications, bleeding, seroma, infection, lymphocele, and renal failure. Meanwhile, there is also a high possibility of urinary diversion related intestinal obstruction, anastomotic stenosis or fistula, ureteric obstruction, hydronephrosis, pyelonephritis, and urinary dysfunction [49][50][51]. Thereupon, in view of the incidence of complications and potential mortality, surgeons should choose cystoprostatectomy with full consideration for highly selected LAPC patients and explicitly apprise patients of these risks to obtain their informed consent.…”