Perioperative Complications of Radical Cystectomy in a Contemporary Series

Novotný, Vladimír; Hakenberg, Oliver W.; Wiessner, D.; Heberling, Ulrike; Litz, R. J.; Oehlschlaeger, Sven; Wirth, Manfred P.

doi:10.1016/j.eururo.2006.06.014

Cited by 259 publications

(157 citation statements)

References 15 publications

Supporting

Mentioning

132

Contrasting

Unclassified

Order By: Relevance

“…In our study, the high-grade complication rate and mortality risk with UD was higher than that reported in contemporary series of radical cystectomy and UD for bladder cancer [14][15][16] . Schiavina et al (2013) .…”

Section: Accepted Manuscriptcontrasting

confidence: 49%

Urinary Diversion for Severe Urinary Adverse Events of Prostate Radiation: Results from a Multi-Institutional Study

et al. 2017

View full text Add to dashboard Cite

Section: Accepted Manuscriptcontrasting

confidence: 49%

Urinary Diversion for Severe Urinary Adverse Events of Prostate Radiation: Results from a Multi-Institutional Study

et al. 2017

View full text Add to dashboard Cite

“…Clavien grade 3 or higher). Nevertheless, the rates and magnitude of these complications where on a par with those in well established open cystectomy literature (21)(22)(23).…”

Section: Discussionmentioning

confidence: 92%

Robotic-assisted laparoscopic radical cystectomy: surgical and oncological outcomes

Treiyer¹,

Saar²,

Bütow³

et al. 2012

Int. braz j urol.

View full text Add to dashboard Cite

InTRODUcTIOnRobotic-assisted laparoscopic radical cystectomy has become a surgical option for patients with bladder cancer, providing the benefi ts of minimal invasive surgery with lower blood loss, early return of bowel function and more rapid patient recovery, while apparently maintaining functional and oncological outcomes (1-6). The surgical and perioperative outcomes of initial reports appear to be comparable to the open approach. However, larger experiences are required to adequately evaluate and validate this procedure as an appropriate surgical and oncological method for patients with bladder cancer. We report our initial experience with robotic assisted laparoscopic radical cystectomy, evaluating the perioperative and pathological outcomes of this procedure.Purpose: Our fi rst 91 consecutive cases undergoing a robotic assisted cystectomy were analyzed regarding perioperative outcomes, pathological stages and surgical complications. Materials and Methods: Between 2007 and 2010 a total of 91 patients (76 male and 15 female), 86 with clinically localized bladder cancer and 5 with non-urothelial tumors underwent a radical robotic assisted cystectomy. We analyzed the perioperative factors, length of hospital stay, pathological outcomes and complication rates. Results: Mean age was 65.6 years (range 28 to 82). Among the 91 patients, 68 were submitted to an ileal conduit and 23 to a neobladder procedure for urinary diversion. Mean operating time was 412 min (range: 243-618 min.) and mean blood loss was 294 mL (range: 50-2000 mL). In 29% of the cases with urothelial carcinoma the T-stage was pT1 or less, 38% were pT2; 26% and 7% were classifi ed as pT3 and pT4, respectively. 14% of cases had lymph node positive disease. Mean number of lymph nodes removed was 15 (range 4 to 33). Positive surgical margins occurred in 2 cases (2.1%). Mean days to fl atus were 2.13, bowel movement 2.88 and inpatient stay 18.8 (range: 10-33). There were 45 postoperative complications with 11% major (Clavien grade 3 or higher). At a mean follow-up of 15 months 10 patients had disease recurrence and 6 died of the disease. Conclusions: Our experience demonstrates that robotic assisted radical cystectomies for the treatment of bladder cancers seems to be very promising regarding surgical and oncological outcomes. Robotic

show abstract

“…3,7,67,68 The etiology of postoperative ileus is multifactoral, with bowel function relying on a combination of the enteric and central nervous systems, hormonal influences, neurotransmitters and local inflammatory pathways. 69 Surgical stress, bowel handling, opioids and intraoperative fluid resuscitation can disrupt these normal arrangements within the gastrointestinal tract and lead to postoperative ileus and impaired gastrointestinal absorptive function.…”

Section: Prevention Of Prolonged Postoperative Ileusmentioning

confidence: 99%

“…Overall complication rates have been reported as high as 64% at 90 days, 2 with an average in-patient stay of 17.4 days. 3 Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization.…”

Section: Introductionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

261

120

View full text Add to dashboard Cite

Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

show abstract

Perioperative Complications of Radical Cystectomy in a Contemporary Series

Cited by 259 publications

References 15 publications

Urinary Diversion for Severe Urinary Adverse Events of Prostate Radiation: Results from a Multi-Institutional Study

Urinary Diversion for Severe Urinary Adverse Events of Prostate Radiation: Results from a Multi-Institutional Study

Robotic-assisted laparoscopic radical cystectomy: surgical and oncological outcomes

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Contact Info

Product

Resources

About