Cystectomy for benign disease: readmission, morbidity, and complications

Autor:	Scott G, Erpelding, Adam, Dugan, Sudhir, Isharwal, Stephen, Strup, Andrew, James, Shubham, Gupta
Rok vydání:	2018
Předmět:	Male Reoperation Databases Factual Operative Time Smoking Urinary Bladder Diseases Length of Stay Middle Aged Urinary Diversion Cystectomy Patient Readmission Postoperative Complications Urinary Bladder Neoplasms Sepsis Surgical Wound Dehiscence Humans Surgical Wound Infection Female Aged
Zdroj:	The Canadian journal of urology. 25(5)
ISSN:	1195-9479 2007-2015
Popis:	We sought to elucidate outcomes and risks associated with cystectomy and urinary diversion for benign urological conditions compared to malignant conditions.We identified patients who underwent cystectomy and urinary diversion for benign and malignant diseases through the American College of Surgeons National Surgery Quality Improvement Program database for the period 2007-2015. Patients were selected for inclusion based upon their current procedure terminology and International Classification of Disease, Ninth revision codes. Primary outcome was 30 day morbidity including return to the operating room (OR); infectious, respiratory, and/or cardiovascular complications; readmission to the hospital; and mortality. Multivariable regression analyses were performed to identify associated factors.A total of 317 patients underwent cystectomy and urinary diversion for benign disease, and 5510 patients underwent radical cystectomy with urinary diversion for cancer. Rates of major morbidity (43.2% versus 38.6%), mortality (0.9% versus 1.9%), return to OR (5% versus 5.8%), readmission (19.7% versus 21.4%), postoperative sepsis (14.5% versus 12%), and wound complications (16.1% versus 14.2%) were similar among patients undergoing cystectomy for benign and malignant conditions. In the group with cystectomy for benign conditions, smoking (OR: 3.11) and longer operative duration (OR: 1.06) were significantly associated with increased overall morbidity. Wound complications were significantly higher in smokers (OR: 3.09) and with an ASA ≥ III (OR: 5.71) CONCLUSIONS: Patients undergoing cystectomy and urinary diversion for benign disease are at similar risk for 30 day morbidity and mortality as patients undergoing surgery for malignant conditions. Risk factors are identified that can potentially be targeted for morbidity reduction.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::c483dbd7e7e5037aad78596c11f89964 https://pubmed.ncbi.nlm.nih.gov/30281004 Zobrazit plný text záznamu