AB117. Analysis of perioperative outcome and complications following radical cystectomy: a single center retrospective study of 1,212 patients in two decades

OBJECTIVE: Radical cystectomy remains the preferred treatment option for patients with advanced, localised urothelial bladder cancer, which is still a challenging procedure associated with longer operative time, more perioperative complications, longer lengths of stay and slower recovery. This retrospective study analyzed the clinical characteristics and perioperative complications of the patients with radical cystectomy in 20 years. METHODS: A retrospective study reviewed 1,212 patients who received radical cystectomy from January 1995 to December 2014 in Urological Department, Peking University First Hospital. We divided the patients into three groups by the time when they received the surgery (group A from January 1995 to December 2004, group B from January 2005 to December 2009, and group C from January 2010 to December 2014) and compared the perioperative outcome and complications among the three groups. RESULTS: There are 227 patients for group A, 368 for group B and 617 for group C. For clinical features of the different groups, the age was 61.73±12.886, 63.79±11.414, and 65.25±11.22 years for each group (P<0.001). The body mass index (BMI) was 18.58±5.439, 23.74±3.791, 24.08±5.65 kg/m(2) for each group (P<0.001). There were no statistically significant differences in gender, underlying disease, history of surgery, or American Society of Anesthesiologists (ASA) scores. For operative and perioperative features, There were statistically significant differences in operation time (401.8±99.39, 371.5±95.41, 306.4±100.49 min, P<0.001), estimated blood loss (1,608.4±1,127.05, 1,645.1±2,083.38, 690±813.87 mL, P<0.001), blood transfusion rate (P=0.001), open or laparoscopic surgery (P<0.001), different urinary diversion reconstruction methods (P<0.001) and length of stay (44.1±21.16, 31.71±18.76, 19.9±14.86 day, P<0.001). However, there was no statistically significant difference in pathological features or postoperative complications among the three groups. CONCLUSIONS: For patients received radical cystectomy, the age and BMI were increased with the passage of time, with shorter operative time, reduced the amount of bleeding and the rate of allogeneic transfusion. Also, more patients received laparoscopic surgery and the length of hospital stay was shorter. However, pathological features or postoperative complications seems not to change along with time.