Perioperative Blood Transfusion and Radical Cystectomy: Does Timing of Transfusion Affect Bladder Cancer Mortality?

Abel, E. Jason; Linder, Brian J.; Bauman, Tyler M.; Bauer, Rebecca; Thompson, R. Houston; Thapa, Prabin; Devon, Octavia N.; Tarrell, Robert F.; Frank, Igor; Jarrard, David F.; Downs, Tracy M.; Boorjian, Stephen A.

doi:10.1016/j.eururo.2014.08.051

Cited by 74 publications

(90 citation statements)

References 28 publications

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“…Additionally, our RARC transfusion rates of 8% was also comparable with the reported 14.7% and 7% for intracorporeal ileal conduits and neobladders, respectively . Our ORC transfusion rate was 31%, which is encouraging in comparison to 41.6–67% in the literature . LOS of 8 days for RARC and 10 days for ORC is equivalent to the available published data …”

Section: Discussionsupporting

confidence: 81%

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

Chow

Zargar

Corcoran

et al. 2018

ANZ Journal of Surgery

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Section: Discussionsupporting

confidence: 81%

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

Chow

Zargar

Corcoran

et al. 2018

ANZ Journal of Surgery

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“…Other studies have already shown great discrepancy in total transfusion rates after cystectomy from 30%26 to 69%;27 a striking fact that is represented by the high incidence of grade 2 complications, which is also defined through the supportive postoperative blood transfusion. We saw up to 48% of grade 2 complications in period A and 11.5% of grade 2 complication in period B only due to blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital

Mani¹,

Vallo²,

Brandt³

et al. 2016

PPA

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PurposeThis study compares early complications after cystectomy and urinary diversion (UD) stratified by the surgical focus and case load of two different department chairpersons in a single institution in two time periods. Creating clear data about complications that can affect the quality of life is an important tool for patients to decide whether and where to perform this extensive surgery.HypothesisA team of surgeons with a clear focus on pelvic surgery leads to lower complication rates in radical cystectomy.Materials and methodsRadical cystectomy was performed in two separate time periods under the patronage of two different chairmen in the same university hospital. The patient data were analyzed retrospectively and the complications 30 days after surgery were assessed using the Clavien–Dindo classification.ResultsStatistical analysis showed a significant difference in the severity of complications between the two time periods, A and B, in total (P<0.001). When placing patients into subgroups, significantly more complications in period A were also seen concerning sex (male, P<0.001; female, P=0.003), age (<70 years, P<0.001; >70 years, P≤50.001) tumor grade (low grade, P<0.001; high grade, P≤0.001), and UD (ileal conduit, P<0.001; neobladder, P<0.001). In a multivariable analysis, age (P=0.031) and type of UD (P=0.028) were determined as independent predictors for complications in period A. When joining the two periods together, the type of UD (P=0.0417), age (P=0.041), and the time periods (A/B) (P<0.001) show a significant association with the presence of complications.ConclusionThis study compares for the first time surgical complications in two time periods with different case load and surgical focus in one department. Categorization shows that patients should prefer radical cystectomy in centers of excellence or a high-volume hospital in order to keep complications at the lowest possible level and thus have the highest benefit for oncologic outcome and quality of life.

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“…Abel et al reported in a cohort of 360 patients that the intraoperative and not the postoperative transfusion was correlated with worse OS and recurrence. 31 In contrast, in a very recent study from Buchner et al in 722 patients with 26 months of follow up, they saw a negative and dose-dependent impact of transfusion, irrespective of timing and stage of the bladder cancer. 32 The same result was recorded by Siemens et al, who apart from worse survival, they also recorded an association of transfusion with poorer early outcomes, such as LOS and re-admission rates.…”

Section: Perioperative Outcomesmentioning

confidence: 85%

“…Abel et al . reported in a cohort of 360 patients that the intraoperative and not the postoperative transfusion was correlated with worse OS and recurrence . In contrast, in a very recent study from Buchner et al .…”

Section: Perioperative Outcomesmentioning

confidence: 88%

Is the open cystectomy era over? An update on the available evidence

Tyritzis

Wiklund

2017

Int J of Urology

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In 2018, robot-assisted radical cystectomy will enter its 15th year. In an era where an effort is being made to standardize complication reporting and videos of the procedure are readily available, it is inevitable and justified that like everything novel, robot-assisted radical cystectomy should be scrutinized against the gold standard, open radical cystectomy. The present comparison is focused on several parameters: oncological, functional and complication outcomes, and direct and indirect costs. Metaanalysis and prospective randomized trials comparing robot-assisted radical cystectomy versus open radical cystectomy have been published, showing an oncological equivalence and in some cases an advantage of robot-assisted radical cystectomy in terms of postoperative morbidity. In the present review, we attempt to update the available knowledge on this debate and discuss the limitations of the current evidence that prevent us from drawing safe conclusions.

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Perioperative Blood Transfusion and Radical Cystectomy: Does Timing of Transfusion Affect Bladder Cancer Mortality?

Cited by 74 publications

References 28 publications

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital

Is the open cystectomy era over? An update on the available evidence

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Perioperative Blood Transfusion and Radical Cystectomy: Does Timing of Transfusion Affect Bladder Cancer Mortality?

Cited by 74 publications

References 28 publications

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

Robotic‐assisted radical cystectomy with intracorporeal urinary diversion versus open: early Australian experience

What should be the patient&#39;s preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital

Is the open cystectomy era over? An update on the available evidence

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What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital