Journal article
Complications After Robot-assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium
European urology, Vol.64(1), pp.52-57
07/2013
DOI: 10.1016/j.eururo.2013.01.010
PMID: 23380164
Abstract
Complication reporting is highly variable and nonstandardized. Therefore, it is imperative to determine the surgical outcomes of major oncologic procedures.
To describe the complications after robot-assisted radical cystectomy (RARC) using a standardized and validated reporting methodology.
Using the International Robotic Cystectomy Consortium (IRCC) database, we identified 939 patients who underwent RARC, had available complication data, and had at least 90 d of follow-up.
Complications were analyzed and graded according to the Memorial Sloan-Kettering Cancer Center (MSKCC) system and were defined and stratified by organ system. Secondary outcomes included identification of preoperative and intraoperative variables predicting complications. Logistic regression models were used to define predictors of complications and readmission.
Forty-one percent (n=387) and 48% (n=448) of patients experienced a complication within 30 and 90 d of surgery, respectively. The highest grade of complication was grade 0 in 52%, grade 1–2 in 29%, and grade 3–5 in 19% patients. Gastrointestinal, infectious, and genitourinary complications were most common (27%, 23%, and 17%, respectively). On multivariable analysis, increasing age group, neoadjuvant chemotherapy, and receipt of blood transfusion were independent predictors of any and high-grade complications, respectively. Thirty and 90-d mortality was 1.3% and 4.2%, respectively. As a multi-institutional database, a disparity in patient selection, operating standards, postoperative management, and reporting of complications can be considered a major limitation of the study.
Surgical morbidity after RARC is significant when reported using a standardized reporting methodology. The majority of complications are low grade. Strict reporting of complications is necessary to advocate for radical cystectomy (RC) and helps in patient counseling.
Our goal was to describe the complications after robot-assisted radical cystectomy (RARC) using a standardized and validated reporting methodology. When using multi-institutional data, surgical morbidity after RARC is significant, but most complications are low grade.
Details
- Title: Subtitle
- Complications After Robot-assisted Radical Cystectomy: Results from the International Robotic Cystectomy Consortium
- Creators
- Raza S Johar - Roswell Park Cancer Institute, Buffalo, NY, USAMatthew H Hayn - Maine Medical Center, Portland, Maine, USAAndrew P Stegemann - Roswell Park Cancer Institute, Buffalo, NY, USAKamran Ahmed - Guy's and St Thomas’ Hospitals, London, United KingdomPiyush Agarwal - Henry Ford Health System, Detroit, MI, USAM. Derya Balbay - Ankara Ataturk Training and Research Hospital, Ankara, TurkeyAshok Hemal - Wake Forest University, Winston-Salem, NC, USAAdam S Kibel - Washington University School of Medicine, St. Louis, MO, USAFred Muhletaler - Henry Ford Health System, Detroit, MI, USAKenneth Nepple - Washington University School of Medicine, St. Louis, MO, USAJohn G Pattaras - Emory University School of Medicine, Atlanta, GA, USAJames O Peabody - Henry Ford Health System, Detroit, MI, USAJoan Palou Redorta - Fundacio Puigvert, Barcelona, SpainKoon-Ho Rha - Yonsei University Health System Severance Hospital, Seoul, South KoreaLee Richstone - Arthur Smith Institute for Urology, Long Island, NY, USAMatthias Saar - Saarland University Clinic, Homburg, GermanyFrancis Schanne - Urology Associates of Delaware, Wilmington, DE, USADouglas S Scherr - Weil Cornell Medical College, New York, NY, USAStefan Siemer - Saarland University Clinic, Homburg, GermanyMichael Stökle - Saarland University Clinic, Homburg, GermanyAlon Weizer - University of Michigan, Ann Arbor, MI, USAPeter Wiklund - Karolinska University, Stockholm, SwedenTimothy Wilson - City of Hope, Duarte, CA, USAMichael Woods - Loyola University Medical Center, Maywood, IL, USABertrum Yuh - City of Hope, Duarte, CA, USAKhurshid A Guru - Roswell Park Cancer Institute, Buffalo, NY, USA
- Resource Type
- Journal article
- Publication Details
- European urology, Vol.64(1), pp.52-57
- DOI
- 10.1016/j.eururo.2013.01.010
- PMID
- 23380164
- NLM abbreviation
- Eur Urol
- ISSN
- 0302-2838
- eISSN
- 1873-7560
- Publisher
- Elsevier B.V
- Language
- English
- Date published
- 07/2013
- Academic Unit
- Urology
- Record Identifier
- 9984051995102771
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