Analysis of radical cystectomy and urinary diversion complications with the Clavien classification system in an Italian real life cohort.
Eur J Surg Oncol
; 39(7): 792-8, 2013 Jul.
Article
en En
| MEDLINE
| ID: mdl-23562571
ABSTRACT
INTRODUCTION:
Standardized methods of reporting complications after radical cystectomy (RC) and urinary diversions (UD) are necessary to evaluate the morbidity associated with this operation to evaluate the modified Clavien classification system (CCS) in grading perioperative complications of RC and UD in a real life cohort of patients with bladder cancer. MATERIALS ANDMETHODS:
A consecutive series of patients treated with RC and UD from April 2011 to March 2012 at 19 centers in Italy was evaluated. Complications were recorded according to the modified CCS. Results were presented as complication rates per grade. Univariate and binary logistic regression analysis were used for statistical analysis. RESULTS ANDLIMITATIONS:
467 patients were enrolled. Median age was 70 years (range 35-89). UD consisted in orthotopic neobladder in 112 patients, ileal conduit in 217 patients and cutaneous ureterostomy in 138 patients. 415 complications were observed in 302 patients and were classified as Clavien type I (109 patients) or II (220 patients); Clavien type IIIa (45 patients), IIIb (22 patients); IV (11 patients) and V (8 patients). Patients with cutaneous ureterostomy presented a lower rate (8%) of CCS type ≥IIIa (p = 0.03). A longer operative time was an independent risk factor of CCS ≥III (OR 1.005; CI 1.002-1.007 per minute; p = 0.0001).CONCLUSIONS:
In our study, RC is associated with a significant morbidity (65%) and a reduced mortality (1.7%) when compared to previous experiences. The modified CCS represents an easily applicable tool to classify the complications of RC and UD in a more objective and detailed way.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Derivación Urinaria
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Neoplasias de la Vejiga Urinaria
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Carcinoma de Células Transicionales
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Cistectomía
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Evaluation_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
Límite:
Adult
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Surg Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2013
Tipo del documento:
Article
País de afiliación:
Italia