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Comparative study of postoperative complications after radical cystectomy during the past two decades in Japan: Radical cystectomy remains associated with significant postoperative morbidities

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Title: Comparative study of postoperative complications after radical cystectomy during the past two decades in Japan: Radical cystectomy remains associated with significant postoperative morbidities
Authors: Yamada, Shuhei Browse this author
Abe, Takashige Browse this author →KAKEN DB
Sazawa, Ataru Browse this author
Katano, Hidenori Browse this author
Suzuki, Hidetaka Browse this author
Takeuchi, Ichiro Browse this author
Ishizaki, Junji Browse this author
Minami, Keita Browse this author
Morita, Ken Browse this author
Tsuchiya, Kunihiko Browse this author
Takada, Norikata Browse this author
Maru, Shintaro Browse this author
Ishikawa, Shuhei Browse this author
Sato, Soshu Browse this author
Kawazu, Takafumi Browse this author
Yamashita, Takanori Browse this author
Ono, Takenori Browse this author
Mochizuki, Tango Browse this author
Akino, Tomoshige Browse this author
Sasaki, Yoshihiro Browse this author
Shinno, Yuichiro Browse this author
Furumido, Jun Browse this author
Miyata, Haruka Browse this author
Kikuchi, Hiroshi Browse this author
Matsumoto, Ryuji Browse this author
Osawa, Takahiro Browse this author
Shinohara, Nobuo Browse this author →KAKEN DB
Keywords: Complication
Radical cystectomy
Bladder cancer
Issue Date: Jan-2022
Publisher: Elsevier
Journal Title: Urologic oncology
Volume: 40
Issue: 1
Start Page: 11.e17
End Page: 11.e25
Publisher DOI: 10.1016/j.urolonc.2021.09.005
Abstract: Objectives: During the past 2 decades, in order to improve perioperative and ontological outcomes, a minimally invasive approach, neoadjuvant chemotherapy (NAC), and an enhanced postoperative recovery program after surgery have been introduced into routine clinical practice of radical cystectomy (RC). Our aim was to examine the differences in clinical practice and postoperative complications after RC by comparing our previous and current cohorts. Materials and methods: A retrospective multi-institutional study. We collected all complications within 90 days after surgery between 2011 and 2017 (current cohort), and categorized them according to a standardized methodology. Then, we compared the outcomes with those in our previous study (previous cohort, 1997-2010). A multivariate logistic regression model was utilized to determine predictors of complications in the current cohort. Results: A total of 838 patients were newly collected (current cohort), and 919 from the previous cohort were included in the subsequent analyses. In the current cohort, the rate of performing NAC was significantly higher (13% vs. 4%, respectively, P < 0.0001), and 26% (222/ 838) underwent laparoscopic RC (LRC, without robotic assistance: n = 210, with robotic assistance: n = 12). There was no significant difference in the overall complication [69% (580/838) vs. 68% (629/919), respectively, P = 0.7284] or major complication (Grades 3-5) [25% (211/838) vs. 22% (201/919), respectively, P = 0.1022] rates between the 2 cohorts. In both cohorts, the most frequent categories were infectious, gastrointestinal, wound-related, and genitourinary. In the current cohort, the performance status (odds ratio, OR = 2.11, P = 0.0013) and operative time (OR = 1.003, P = 0.0016) remained significant predictors of major complications. NAC was not associated with any or major complications. Conclusions: Surgical complications related to RC still remain significant problems, despite the recent improvements in surgical techniques and perioperative care. NAC did not increase the complications. (C) 2021 The Authors. Published by Elsevier Inc.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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