Standardized analysis of complications after robot-assisted radical cystectomy: Korea university hospital experience

Jong Hyun Pyun, Hyung Keun Kim, Jae Yoon Kim, Seung Bin Kim, Seok Cho, Sung-Gu Kang, Young Hwii Ko, Jun Cheon, Jeong Gu Lee, Je-Jong Kim, Seok Ho Kang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To analyze the complications after robot-assisted radical cystectomy (RARC) by use of a standardized reporting methodology by a single surgeon.

Materials and Methods: We prospectively reviewed a maintained institutional database of 52 patients who underwent RARC to manage bladder cancer and were followed up in 3 months by a single surgeon at Korea University Medical Center from 2007 through 2014. All complications within 90 days of surgery were defined and categorized into 5 grades according to the Clavien-Dindo classification. Logistic regression analysis was used to identify predictors of complications.

Results: Fifty percent of patients (26 of 52) experienced a complication of any grade <90 days after surgery, and 11 patients (21.2%) experienced a major complication. Complications were grouped in systems-based categories. Fifty complications occurred in 52 patients and hematologic complication (transfusion) was the most common (13 of 52). Wound dehiscence, anastomotic leakage, urinary tract obstruction, mechanical obstruction, and thromboembolism occurred as major complications. Mean estimated blood loss (EBL) was 247 mL and mean total operative time was 496 minutes. The mean number of lymph nodes harvested was 24.6, with 30.5 for extended dissection. EBL (over 300 mL), operative time, and method of urinary diversion were significant negative predictors of minor complications, whereas EBL (over 300 mL) was a significant negative predictor of major complications (p<0.05).

Conclusions: The present results show that the complication rate reported by use of a standardized methodology after robotic radical cystectomy is still considerable although comparable to that of contemporary robot series. EBL, operative time, and diversion methods were predictors of complications.

Original languageEnglish
Pages (from-to)48-55
Number of pages8
JournalKorean Journal of Urology
Volume56
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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Cystectomy
Korea
Operative Time
Ambulatory Surgical Procedures
Anastomotic Leak
Urinary Diversion
Thromboembolism
Robotics
Urinary Tract
Urinary Bladder Neoplasms
Dissection
Logistic Models
Lymph Nodes
Regression Analysis
Databases
Wounds and Injuries
Surgeons

Keywords

  • Cystectomy
  • Postoperative complication
  • Robotics
  • Urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Standardized analysis of complications after robot-assisted radical cystectomy : Korea university hospital experience. / Pyun, Jong Hyun; Kim, Hyung Keun; Kim, Jae Yoon; Kim, Seung Bin; Cho, Seok; Kang, Sung-Gu; Ko, Young Hwii; Cheon, Jun; Lee, Jeong Gu; Kim, Je-Jong; Kang, Seok Ho.

In: Korean Journal of Urology, Vol. 56, No. 1, 01.01.2015, p. 48-55.

Research output: Contribution to journalArticle

Pyun, Jong Hyun ; Kim, Hyung Keun ; Kim, Jae Yoon ; Kim, Seung Bin ; Cho, Seok ; Kang, Sung-Gu ; Ko, Young Hwii ; Cheon, Jun ; Lee, Jeong Gu ; Kim, Je-Jong ; Kang, Seok Ho. / Standardized analysis of complications after robot-assisted radical cystectomy : Korea university hospital experience. In: Korean Journal of Urology. 2015 ; Vol. 56, No. 1. pp. 48-55.
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AU - Pyun, Jong Hyun

AU - Kim, Hyung Keun

AU - Kim, Jae Yoon

AU - Kim, Seung Bin

AU - Cho, Seok

AU - Kang, Sung-Gu

AU - Ko, Young Hwii

AU - Cheon, Jun

AU - Lee, Jeong Gu

AU - Kim, Je-Jong

AU - Kang, Seok Ho

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N2 - Purpose: To analyze the complications after robot-assisted radical cystectomy (RARC) by use of a standardized reporting methodology by a single surgeon.Materials and Methods: We prospectively reviewed a maintained institutional database of 52 patients who underwent RARC to manage bladder cancer and were followed up in 3 months by a single surgeon at Korea University Medical Center from 2007 through 2014. All complications within 90 days of surgery were defined and categorized into 5 grades according to the Clavien-Dindo classification. Logistic regression analysis was used to identify predictors of complications.Results: Fifty percent of patients (26 of 52) experienced a complication of any grade <90 days after surgery, and 11 patients (21.2%) experienced a major complication. Complications were grouped in systems-based categories. Fifty complications occurred in 52 patients and hematologic complication (transfusion) was the most common (13 of 52). Wound dehiscence, anastomotic leakage, urinary tract obstruction, mechanical obstruction, and thromboembolism occurred as major complications. Mean estimated blood loss (EBL) was 247 mL and mean total operative time was 496 minutes. The mean number of lymph nodes harvested was 24.6, with 30.5 for extended dissection. EBL (over 300 mL), operative time, and method of urinary diversion were significant negative predictors of minor complications, whereas EBL (over 300 mL) was a significant negative predictor of major complications (p<0.05).Conclusions: The present results show that the complication rate reported by use of a standardized methodology after robotic radical cystectomy is still considerable although comparable to that of contemporary robot series. EBL, operative time, and diversion methods were predictors of complications.

AB - Purpose: To analyze the complications after robot-assisted radical cystectomy (RARC) by use of a standardized reporting methodology by a single surgeon.Materials and Methods: We prospectively reviewed a maintained institutional database of 52 patients who underwent RARC to manage bladder cancer and were followed up in 3 months by a single surgeon at Korea University Medical Center from 2007 through 2014. All complications within 90 days of surgery were defined and categorized into 5 grades according to the Clavien-Dindo classification. Logistic regression analysis was used to identify predictors of complications.Results: Fifty percent of patients (26 of 52) experienced a complication of any grade <90 days after surgery, and 11 patients (21.2%) experienced a major complication. Complications were grouped in systems-based categories. Fifty complications occurred in 52 patients and hematologic complication (transfusion) was the most common (13 of 52). Wound dehiscence, anastomotic leakage, urinary tract obstruction, mechanical obstruction, and thromboembolism occurred as major complications. Mean estimated blood loss (EBL) was 247 mL and mean total operative time was 496 minutes. The mean number of lymph nodes harvested was 24.6, with 30.5 for extended dissection. EBL (over 300 mL), operative time, and method of urinary diversion were significant negative predictors of minor complications, whereas EBL (over 300 mL) was a significant negative predictor of major complications (p<0.05).Conclusions: The present results show that the complication rate reported by use of a standardized methodology after robotic radical cystectomy is still considerable although comparable to that of contemporary robot series. EBL, operative time, and diversion methods were predictors of complications.

KW - Cystectomy

KW - Postoperative complication

KW - Robotics

KW - Urinary diversion

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