Short-term Complication Rates Following Anterior Urethroplasty: An Analysis of National Surgical Quality Improvement Program Data.

Autor: Lacy JM; Department of Urology, University of Tennessee Health Sciences Center Graduate School of Medicine, Knoxville, TN. Electronic address: johnlacy1@gmail.com., Madden-Fuentes RJ; Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC., Dugan A; Department of Urology, University of Kentucky Medical Center, Lexington, KY., Peterson AC; Department of Surgery, Division of Urology, Duke University Medical Center, Durham, NC., Gupta S; Department of Urology, University of Kentucky Medical Center, Lexington, KY.
Jazyk: angličtina
Zdroj: Urology [Urology] 2018 Jan; Vol. 111, pp. 197-202. Date of Electronic Publication: 2017 Aug 18.
DOI: 10.1016/j.urology.2017.08.006
Abstrakt: Objective: To determine the characteristics and predictors of perioperative complications after male anterior urethroplasty.
Materials and Methods: The American College of Surgeons-National Surgical Quality Improvement Program is a validated outcomes-based program comprising academic and community hospitals in the United States and Canada. Data from 2007 to 2015 were queried for single-stage anterior urethroplasty using Current Procedure Terminology codes. The primary outcome was frequency of complications within the 30-day postoperative period. Preoperative and intraoperative parameters were correlated with morbidity measures, and univariate and multivariate regression analyses were used.
Results: A total of 555 patients underwent anterior urethroplasty, of whom 180 (32.4%) had graft or flap placement. Of the patients, 127 (22.9%) went home the same day after surgery, 255 (45.9%) stayed for 1 night, and 173 (31.2%) stayed for 2 or more nights. No deaths, cardiovascular complications, or sepsis were noted. Forty-seven patients (8.5%) had complications in the 30-day period. The most common complications were infection (57.4%), readmission (42.9%), and return to the operating room (17%). On univariate analysis, patients who had substitution urethroplasty (P = .04) and longer operative times (P = .002) were more likely to have complications, but only longer operative time showed significance on multivariate analysis (P = .006). Age, American Society of Anesthesiologists score, and length of stay were not predictive of complication frequency.
Conclusion: Anterior urethroplasty has low postoperative morbidity. Longer operative times were associated with increased rate of complications. Longer hospital stay after surgery is not protective against perioperative complications.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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