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1615 PERIOPERATIVE MORBIDITY AND MORTALITY RELATED TO RADICAL CYSTECTOMY: A MULTI-INSTITUTIONAL RETROSPECTIVE STUDY IN JAPAN

2013; Lippincott Williams & Wilkins; Volume: 189; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2013.02.3165

1527-3792

Takashige Abe, Norikata Takada, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Shino Kanzaki, Yuichiro Shinno, Soushu Sato, K Mitsuhashi, Takuya Sato, Keiji Sugishita, Shinji Kamota, Takanori Yamashita, Junji Ishizaki, Takaya Hioka, Gaku Mouri, Takenori Ono, Naoto Miyajima, Takanori Sakuta, Tango Mochizuki, Toshiki Aoyagi, Hidenori Katano, Tomoshige Akino, Kazushi Hirakawa, Keita Minami, Akira Kumagai, Masaki Togashi, Toshimori Seki, Katsuya Nonomura,

Urological Disorders and Treatments

You have accessJournal of UrologyBladder Cancer: Invasive (II)1 Apr 20131615 PERIOPERATIVE MORBIDITY AND MORTALITY RELATED TO RADICAL CYSTECTOMY: A MULTI-INSTITUTIONAL RETROSPECTIVE STUDY IN JAPAN Takashige Abe, Norikata Takada, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Shino Kanzaki, Yuichiro Shinno, Soushu Sato, Kimiyoshi Mitsuhashi, Takuya Sato, Keiji Sugishita, Shinji Kamota, Takanori Yamashita, Junji Ishizaki, Takaya Hioka, Gaku Mouri, Takenori Ono, Naoto Miyajima, Takanori Sakuta, Tango Mochizuki, Toshiki Aoyagi, Hidenori Katano, Tomoshige Akino, Kazushi Hirakawa, Keita Minami, Akira Kumagai, Masaki Togashi, Toshimori Seki, and Katsuya Nonomura Takashige AbeTakashige Abe Sapporo, Japan , Norikata TakadaNorikata Takada Sapporo, Japan , Nobuo ShinoharaNobuo Shinohara Sapporo, Japan , Ataru SazawaAtaru Sazawa Sapporo, Japan , Satoru MaruyamaSatoru Maruyama Sapporo, Japan , Kunihiko TsuchiyaKunihiko Tsuchiya Sapporo, Japan , Shino KanzakiShino Kanzaki Sapporo, Japan , Yuichiro ShinnoYuichiro Shinno Sapporo, Japan , Soushu SatoSoushu Sato Sapporo, Japan , Kimiyoshi MitsuhashiKimiyoshi Mitsuhashi Sapporo, Japan , Takuya SatoTakuya Sato Sapporo, Japan , Keiji SugishitaKeiji Sugishita Sapporo, Japan , Shinji KamotaShinji Kamota Sapporo, Japan , Takanori YamashitaTakanori Yamashita Sapporo, Japan , Junji IshizakiJunji Ishizaki Sapporo, Japan , Takaya HiokaTakaya Hioka Sapporo, Japan , Gaku MouriGaku Mouri Sapporo, Japan , Takenori OnoTakenori Ono Sapporo, Japan , Naoto MiyajimaNaoto Miyajima Sapporo, Japan , Takanori SakutaTakanori Sakuta Sapporo, Japan , Tango MochizukiTango Mochizuki Sapporo, Japan , Toshiki AoyagiToshiki Aoyagi Sapporo, Japan , Hidenori KatanoHidenori Katano Sapporo, Japan , Tomoshige AkinoTomoshige Akino Sapporo, Japan , Kazushi HirakawaKazushi Hirakawa Sapporo, Japan , Keita MinamiKeita Minami Sapporo, Japan , Akira KumagaiAkira Kumagai Sapporo, Japan , Masaki TogashiMasaki Togashi Sapporo, Japan , Toshimori SekiToshimori Seki Sapporo, Japan , and Katsuya NonomuraKatsuya Nonomura Sapporo, Japan View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3165AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most studies on complications associated with open radical cystectomy (RC) have been derived from Western academic high volume centers, with data from Japan and other Asian countries being very limited. We sought to determine the type, incidence, and severity of 90-day morbidity following radical cystectomy in our institution and affiliated hospitals according to a standard reporting methodology. METHODS A retrospective multi-institutional study. We reviewed the records of 928 patients who underwent open RC between 1997 and 2010. All complications within 90 days of surgery were categorized into 11 specific categories (Gastrointestinal, Infectious, Wound, Genitourinary, Cardiac, Pulmonary, Bleeding, Thromboembolic, Neurological, Miscellaneous, Surgical) reported from the Memorial-Sloan Kettering Cancer Center (Eur Urol, 2009) and graded according to the modified Clavien system. Multivariate regression models were used to determine the predictors of complications. RESULTS Males accounted for 716 (77%) of patients. The median age at RC was 70 years old (range, 25-91). Urinary diversion included an ileal conduit, cutaneous ureterostomy, ileal neobladder, and others in 493 (53%), 248 (27%), 175 (19%), and 12 (1%) patients, respectively. At least 1 complication was observed in 635 patients (68%), and a major (grade 3-5) complication was observed in 156 patients (17%). The most common complication categories were infectious (30%), gastrointestinal (26%), wound-related (21%), and genitourinary (15%), which were common in Western high-volume centers. In contrast, the incidences of cardiac (0.6%) and thromboembolic complications (0.3%) were much lower than in Western centers. The 30-day mortality rate was 0.8% and the 90-day mortality rate was 2%. A multivariate regression model showed that prior cardiovascular comorbidity and the type of urinary diversion (ileal conduit or neobladder) were significant factors for any and major complications. CONCLUSIONS Surgical complications related to radical cystectomy are significant. The most common complication categories were infectious, gastrointestinal, wound-related, and genitourinary, which were consistent with the reports from Western high-volume centers, while the incidences of cardiac (0.6%) and thromboembolic complications (0.3%) were much lower than in Western centers, which suggests an ethnic difference in complications. Prior cardiovascular comorbidity and the type of urinary diversion were significant factors for any and major complications. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e664 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takashige Abe Sapporo, Japan More articles by this author Norikata Takada Sapporo, Japan More articles by this author Nobuo Shinohara Sapporo, Japan More articles by this author Ataru Sazawa Sapporo, Japan More articles by this author Satoru Maruyama Sapporo, Japan More articles by this author Kunihiko Tsuchiya Sapporo, Japan More articles by this author Shino Kanzaki Sapporo, Japan More articles by this author Yuichiro Shinno Sapporo, Japan More articles by this author Soushu Sato Sapporo, Japan More articles by this author Kimiyoshi Mitsuhashi Sapporo, Japan More articles by this author Takuya Sato Sapporo, Japan More articles by this author Keiji Sugishita Sapporo, Japan More articles by this author Shinji Kamota Sapporo, Japan More articles by this author Takanori Yamashita Sapporo, Japan More articles by this author Junji Ishizaki Sapporo, Japan More articles by this author Takaya Hioka Sapporo, Japan More articles by this author Gaku Mouri Sapporo, Japan More articles by this author Takenori Ono Sapporo, Japan More articles by this author Naoto Miyajima Sapporo, Japan More articles by this author Takanori Sakuta Sapporo, Japan More articles by this author Tango Mochizuki Sapporo, Japan More articles by this author Toshiki Aoyagi Sapporo, Japan More articles by this author Hidenori Katano Sapporo, Japan More articles by this author Tomoshige Akino Sapporo, Japan More articles by this author Kazushi Hirakawa Sapporo, Japan More articles by this author Keita Minami Sapporo, Japan More articles by this author Akira Kumagai Sapporo, Japan More articles by this author Masaki Togashi Sapporo, Japan More articles by this author Toshimori Seki Sapporo, Japan More articles by this author Katsuya Nonomura Sapporo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...