| 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 |
| Mortality |
| Reoperation |
| 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 |
| URI: | http://hdl.handle.net/2115/83953 |
| 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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