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Perioperative morbidity of radical cystectomy: A review
A systematic review of the literature on perioperative morbidity (POM) was done using Medline software with a combination of keywords like mortality, morbidity, and complications. In addition, we review the analysis of our hospital data of 261 Radical cystectomies (RCs) performed in an 11-year perio...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142834/ https://www.ncbi.nlm.nih.gov/pubmed/21814314 http://dx.doi.org/10.4103/0970-1591.82842 |
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author | Kulkarni, Jagdeesh N. |
author_facet | Kulkarni, Jagdeesh N. |
author_sort | Kulkarni, Jagdeesh N. |
collection | PubMed |
description | A systematic review of the literature on perioperative morbidity (POM) was done using Medline software with a combination of keywords like mortality, morbidity, and complications. In addition, we review the analysis of our hospital data of 261 Radical cystectomies (RCs) performed in an 11-year period and our latest clinical pathway for RC. Age range in our series was 50 to 81 years with 240 males and 21 females. RCs were performed by intraperitoneal method in 172 patients and by our extraperitoneal (EP) method in 89 patients. Urinary diversion was ileal conduit in 159 patients and neobladder in 102 patients. Blood loss ranged between 500 and 1500 ccs. Postoperative mortality occurred in eight patients (3%). Among the other early post-op complications, major urinary leak was seen in nine and minor in 11, requiring PCN in five patients and reoperation in four patients. Bowel leak or obstruction was seen in six and four patients, respectively, requiring reoperation in six patients. EP RC in our series showed some benefit in reduction of POM. The mortality of RC has declined but the POM still ranges from 11 to 68%, as reported in 23 series (1999-2008) comprising of 14 076 patients. Various risk factors leading to POM and some corrective measures are discussed in detail. However, most of these series are retrospective and lack standard complication reporting, which limits the comparison of outcomes. Various modifications in open surgical technique and laparoscopic and Robotic approaches are aimed at reduction in mortality and POM of RC. |
format | Online Article Text |
id | pubmed-3142834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-31428342011-08-03 Perioperative morbidity of radical cystectomy: A review Kulkarni, Jagdeesh N. Indian J Urol Symposium A systematic review of the literature on perioperative morbidity (POM) was done using Medline software with a combination of keywords like mortality, morbidity, and complications. In addition, we review the analysis of our hospital data of 261 Radical cystectomies (RCs) performed in an 11-year period and our latest clinical pathway for RC. Age range in our series was 50 to 81 years with 240 males and 21 females. RCs were performed by intraperitoneal method in 172 patients and by our extraperitoneal (EP) method in 89 patients. Urinary diversion was ileal conduit in 159 patients and neobladder in 102 patients. Blood loss ranged between 500 and 1500 ccs. Postoperative mortality occurred in eight patients (3%). Among the other early post-op complications, major urinary leak was seen in nine and minor in 11, requiring PCN in five patients and reoperation in four patients. Bowel leak or obstruction was seen in six and four patients, respectively, requiring reoperation in six patients. EP RC in our series showed some benefit in reduction of POM. The mortality of RC has declined but the POM still ranges from 11 to 68%, as reported in 23 series (1999-2008) comprising of 14 076 patients. Various risk factors leading to POM and some corrective measures are discussed in detail. However, most of these series are retrospective and lack standard complication reporting, which limits the comparison of outcomes. Various modifications in open surgical technique and laparoscopic and Robotic approaches are aimed at reduction in mortality and POM of RC. Medknow Publications 2011 /pmc/articles/PMC3142834/ /pubmed/21814314 http://dx.doi.org/10.4103/0970-1591.82842 Text en © Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Symposium Kulkarni, Jagdeesh N. Perioperative morbidity of radical cystectomy: A review |
title | Perioperative morbidity of radical cystectomy: A review |
title_full | Perioperative morbidity of radical cystectomy: A review |
title_fullStr | Perioperative morbidity of radical cystectomy: A review |
title_full_unstemmed | Perioperative morbidity of radical cystectomy: A review |
title_short | Perioperative morbidity of radical cystectomy: A review |
title_sort | perioperative morbidity of radical cystectomy: a review |
topic | Symposium |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142834/ https://www.ncbi.nlm.nih.gov/pubmed/21814314 http://dx.doi.org/10.4103/0970-1591.82842 |
work_keys_str_mv | AT kulkarnijagdeeshn perioperativemorbidityofradicalcystectomyareview |