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Predicting factor analysis of postoperative complications after robot-assisted radical cystectomy: Multicenter KORARC database study

Authors
 Hwanik Kim  ;  Byong Chang Jeong  ;  Sangchul Lee  ;  Ja Hyeon Ku  ;  Tae Gyun Kwon  ;  Tae-Hwan Kim  ;  Seung Hyun Jeon  ;  Sang Hyub Lee  ;  Jong Kil Nam  ;  Wansuk Kim  ;  Ji Youl Lee  ;  Sung Hoo Hong  ;  Koon Ho Rha  ;  Woong Kyu Han  ;  Won Sik Ham  ;  Young Goo Lee  ;  Yong Seong Lee  ;  Sung Yul Park  ;  Young Eun Yoon  ;  Sung Gu Kang  ;  Seok Ho Kang  ;  Jong Jin Oh 
Citation
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.29(9) : 939-946, 2022-09 
Journal Title
INTERNATIONAL JOURNAL OF UROLOGY
ISSN
 0919-8172 
Issue Date
2022-09
MeSH
Cystectomy / adverse effects ; Factor Analysis, Statistical ; Humans ; Postoperative Complications / epidemiology ; Postoperative Complications / etiology ; Postoperative Complications / surgery ; Renal Insufficiency, Chronic* / etiology ; Retrospective Studies ; Robotic Surgical Procedures* / adverse effects ; Robotics* ; Treatment Outcome ; Urinary Bladder Neoplasms*
Keywords
bladder cancer ; minimally invasive surgical procedures ; postoperative complications ; radical cystectomy ; robotic surgical procedures
Abstract
Objectives: To evaluate postoperative complications following robot-assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications.

Methods: Prospectively collected medical records of 730 robot-assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non-complication). We assessed recurrence-free survival, cancer-specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications.

Results: Any total and high-grade complication (Clavien-Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer-specific survival (log-rank P = 0.038, median cancer-specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high-grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications.

Conclusions: Patients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer-specific survival rate.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/iju.14815
DOI
10.1111/iju.14815
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192042
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