Surgical Outcomes and Complications in 1 041 Patients Following Radical Cystectomy in a Single Center
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0516
- VernacularTitle:单中心1 041例膀胱癌根治尿流改道患者手术疗效和并发症
- Author:
Zhen-hua LIU
1
;
Xiang-dong LI
1
;
Ze-fu LIU
1
;
Zi-ke QIN
1
;
Kai YAO
1
;
Hui HAN
1
;
Fang-jian ZHOU
1
;
Zhuo-wei LIU
1
Author Information
1. Department of Urology， Sun Yat-sen University Cancer Center， Guangzhou 510060， China
- Publication Type:Journal Article
- Keywords:
bladder cancer;
robot-assisted laparoscopic surgery;
minimally invasive;
prognosis;
complications
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(5):818-827
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the perioperative safety and complications of radical cystectomy （RC）. MethodsThe clinicopathological indexes， postoperative complications and prognosis of patients who underwent RC at Sun Yat-sen University Cancer Centre from January 2001 to August 2020 were retrospectively collected and analyzed. Among them， patients from 2011 to 2020 were further analyzed and compared according to the open surgery group （ORC）， laparoscopic group （LRC） and robot-assisted laparoscopic group （RARC）. Independent sample t test， Chi-square test， K-M survival curve and other statistical methods were used to describe the complications and prognosis of patients， and Logistic regression was used to analyze the influencing factors of complications of RC. ResultsAmong the 1041 patients who underwent RC surgery from 2001 to 2020， the median age was 63 （55-69） years. In terms of the gender ratio， men were the majority at 86 percent. Compared with that of the first 10 years， the complication rate of the second 10 years decreased significantly （37.4% vs. 26.7%）. Complications of 667 patients who underwent RC surgery were analyzed from 2010 to 2020， with a median follow-up of 34 months. A total of 415 patients were enrolled in the ORC group， 161 in the LRC group， and 91 in the RARC group. Ileal conduit （659 cases， 63.3%） accounted for the highest proportion of all urinary diversion methods， while orthotopic neobladder accounted for the second （343 cases， 32.9%）. The incidence of all grade complications was 30.5%， and the most common complication was urinary complications. The incidence of total complications and grade ≥3 complications in the ORC group was higher than that in the LRC and RARC groups （Total complications： ORC， 30.8%； LRC，21.1%， RARC，24.2%； P=0.047； Grade ≥3 complications： ORC， 14.7%； LRC，9.3%； RARC，6.6%； P=0.043）. ConclusionsWith the improvement of surgical techniques and experience， the incidence of recent postoperative complications after radical resection of bladder cancer in our center has decreased. Compared with open surgery， minimally invasive surgery has some advantages in reducing the complication rate.
