Understanding Simple Cystectomy for Benign Disease: A Unique Patient Cohort With Significant Risks
| Autor: | Henry Tran, Michael J Lipsky, Carrie M. Aisen, Doreen E. Chung |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cardiovascular Complication Urology medicine.medical_treatment Urinary Bladder 030232 urology & nephrology Cystectomy Risk Assessment 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Aged Wound dehiscence business.industry Urinary Bladder Diseases Odds ratio Perioperative Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis Current Procedural Terminology Complication business Kidney disease |
| Zdroj: | Urology. 110 |
| ISSN: | 1527-9995 2005-2014 |
| Popis: | Objective To explore patient characteristics and complications of simple cystectomy for benign disease. A secondary objective was to compare these parameters to those in radical cystectomy. Methods Current Procedural Terminology codes were used to identify patients within the National Surgical Quality Improvement Program who underwent cystectomy (2005-2014). International Classification of Disease, Ninth Revision, codes were used to classify patients with benign or malignant diagnoses. Perioperative complications (30 days) were identified and logistic regression analysis was used to identify factors associated with morbidity. Results We identified 389 patients who had a cystectomy for benign diagnosis. A total of 235 patients (60.4%) had complications. The most frequently reported complication was bleeding (requiring a transfusion within 72 hours) in 150 patients (38.6%). Other complications were wound infection (63, 16.2%), respiratory complication (29, 7.5%), wound dehiscence (8, 2.1%), renal complication (9, 2.3%), cardiovascular complication (6, 1.5%), and postoperative deep vein thrombosis (8; 2.1). On multivariate analysis, diabetes (odds ratio 1.9, P = .04) and smoking (odds ratio 1.8, P = .03) were associated with increased odds of any complication. Compared with those with cystectomy for malignancy, this cohort was younger, with higher American Society of Anesthesiologists scores, and chronic kidney disease stages, and the complication risk was similar (60.4% vs 57.7%, P = .3). Conclusion Our data suggest that the benign and radical cystectomy patients are different patient populations, with benign patients being younger with a higher American Society of Anesthesiologists class. Even in benign disease, cystectomy is not without risk, and patients should be counseled accordingly. |
| Databáze: | OpenAIRE |
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