scholarly journals Updated assessment of neoblader utilization and morbidity according to urinary diversion after radical cystectomy: A contemporary US-population-based cohort

2013 ◽  
Vol 7 (9-10) ◽  
pp. 552 ◽  
Author(s):  
Florian Roghmann ◽  
Andreas Becker ◽  
Quoc-Dien Trinh ◽  
Orchidee Djahagirian ◽  
Zhe Tian ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
High Volume ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Morbidity And Mortality ◽  
Utilization Rate ◽  
Prolonged Length ◽  
To Receive

Background: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC.Methods: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality.Results: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]:1.15, p = 0.04).Interpretation: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.

scholarly journals Complications of Radical Cystectomy and Orthotopic Reconstruction

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Shen Tan ◽  
Benjamin W. Lamb ◽  
John D. Kelly
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Late Complications ◽  
Minimal Invasive ◽  
Morbidity And Mortality ◽  
Direct Result ◽  
The Uk

Radical cystectomy and orthotopic reconstruction significant morbidity and mortality despite advances in minimal invasive and robotic technology. In this review, we will discuss early and late complications, as well as describe efforts to minimize morbidity and mortality, with a focus on ileal orthotopic bladder substitute (OBS). We summarise efforts to minimize morbidity and mortality including enhanced recovery as well as early and late complications seen after radical cystectomy and OBS. Centralisation of complex cancer services in the UK has led to a fall in mortality and high volume institutions have a significantly lower rate of 30-day mortality compared to low volume institutions. Enhanced recovery pathways have resulted in shorter length of hospital stay and potentially a reduction in morbidity. Early complications of radical cystectomy occur as a direct result of the surgery itself while late complications, which can occur even after 10 years after surgery, are due to urinary diversion. OBS represents the ideal urinary diversion for patients without contraindications. However, all patients with OBS should have regular long term follow-up for oncological surveillance and to identify complications should they arise.

PD9-10 TIMING OF URETERAL STENT REMOVAL AND POSTOPERATIVE COMPLICATIONS FOLLOWING RADICAL CYSTECTOMY WITH URINARY DIVERSION

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Justin Matulay ◽  
Christopher Sayegh ◽  
Julia Finkelstein ◽  
Mark Silva ◽  
G. Joel DeCastro
Keyword(s):  
Postoperative Complications ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ureteral Stent ◽  
Stent Removal

Population-based trends in urinary diversion among patients undergoing radical cystectomy for bladder cancer

2013 ◽  
Vol 112 (4) ◽  
pp. 478-484 ◽  
Author(s):  
Simon P. Kim ◽  
Nilay D. Shah ◽  
Christopher J. Weight ◽  
R. Houston Thompson ◽  
Jeffrey K. Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Population Based

Population-based analyses of radical cystectomy and urinary diversion for bladder cancer in northern Italy

2011 ◽  
Vol 108 (8b) ◽  
pp. E266-E271 ◽  
Author(s):  
Ugo Fedeli ◽  
Giacomo Novara ◽  
Claudia Galassi ◽  
Vincenzo Ficarra ◽  
Elena Schievano ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Population Based ◽  
Northern Italy

scholarly journals Morbidity and mortality after liver surgery for colorectal liver metastases: a cohort study in a high-volume fast-track programme

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlotte Egeland ◽  
Andreas Arendtsen Rostved ◽  
Nicolai Aagaard Schultz ◽  
Hans-Christian Pommergaard ◽  
Thomas Røjkjær Daugaard ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Liver Metastases ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Fast Track ◽  
High Volume ◽  
Infectious Complications ◽  
Morbidity And Mortality ◽  
Perioperative Morbidity ◽  
Prolonged Length

Abstract Background For colorectal liver metastases, surgery is a high-risk procedure due to perioperative morbidity. The objective was to assess severity of complications after fast-track liver surgery for colorectal liver metastases and their impact on morbidity and mortality. Methods All patients were treated according to the same fast-track programme. Complications were graded according to the Clavien–Dindo classification for patients undergoing surgery from 2013 to 2015. Correlation between complications and length of stay was analysed by multivariate linear regression. Results 564 patient cases were included of which three patients died within 3 months (0.53%, 95% CI: 0.17–1.64%). Complications were common with Grade ≤ 2 in 167 patients (30%) and ≥ Grade 3a in 93 (16%). Patients without complications had a mean length of stay of 4.1 days, which increased with complications: 1.4 days (95% CI: 1.3–1.5) for Grade 2, 1.7 days (1.5–2.0) for Grade 3a, 2.3 days (1.7–3.0) for Grade 3b, 2.6 days (1.6–4.2) for Grade 4a, and 2.9 days (2.8–3.1) for Grade 4b. Following were associated with increased length of stay: complication severity grade, liver insufficiency, ascites, biliary, cardiopulmonary, and infectious complications. Conclusions Complications after liver surgery for colorectal liver metastases, in a fast track setting, were associated with low mortality, and even severe complications only prolonged length of stay to a minor degree.

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