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

Yamada, Shuhei; Abe, Takashige; Sazawa, Ataru; Katano, Hidenori; Suzuki, Hidetaka; Takeuchi, Ichiro; Ishizaki, Junji; Minami, Keita; Morita, Ken; Tsuchiya, Kunihiko; Takada, Norikata; Maru, Shintaro; Ishikawa, Shuhei; Sato, Soshu; Kawazu, Takafumi; Yamashita, Takanori; Ono, Takenori; Mochizuki, Tango; Akino, Tomoshige; Sasaki, Yoshihiro; Shinno, Yuichiro; Furumido, Jun; Miyata, Haruka; Kikuchi, Hiroshi; Matsumoto, Ryuji; Osawa, Takahiro; Shinohara, Nobuo

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

Yamada, Shuhei; Abe, Takashige; Sazawa, Ataru et al.

Urologic oncology, 2022, 40(1), 11.e17-11.e25

Permalink : https://hdl.handle.net/2115/83953

このアイテムのアクセス数:450件（2026-01-17 19:15 集計）

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https://doi.org/10.1016/j.urolonc.2021.09.005

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/83953
タイトル	Comparative study of postoperative complications after radical cystectomy during the past two decades in Japan: Radical cystectomy remains associated with significant postoperative morbidities
著者	Yamada, Shuhei ; Abe, Takashige ; Sazawa, Ataru ; Katano, Hidenori ; Suzuki, Hidetaka ; Takeuchi, Ichiro ; Ishizaki, Junji ; Minami, Keita ; Morita, Ken ; Tsuchiya, Kunihiko ; Takada, Norikata ; Maru, Shintaro ; Ishikawa, Shuhei ; Sato, Soshu ; Kawazu, Takafumi ; Yamashita, Takanori ; Ono, Takenori ; Mochizuki, Tango ; Akino, Tomoshige ; Sasaki, Yoshihiro ; Shinno, Yuichiro ; Furumido, Jun ; Miyata, Haruka ; Kikuchi, Hiroshi ; Matsumoto, Ryuji ; Osawa, Takahiro ; Shinohara, Nobuo
著者名 Yamada, Shuhei
e-Rad_Researcher 10399842 著者名 Abe, Takashige
著者名 Sazawa, Ataru
著者名 Katano, Hidenori
著者名 Suzuki, Hidetaka
著者名 Takeuchi, Ichiro
著者名 Ishizaki, Junji
著者名 Minami, Keita
著者名 Morita, Ken
著者名 Tsuchiya, Kunihiko
著者名 Takada, Norikata
著者名 Maru, Shintaro
著者名 Ishikawa, Shuhei
著者名 Sato, Soshu
著者名 Kawazu, Takafumi
著者名 Yamashita, Takanori
著者名 Ono, Takenori
著者名 Mochizuki, Tango
著者名 Akino, Tomoshige
著者名 Sasaki, Yoshihiro
著者名 Shinno, Yuichiro
著者名 Furumido, Jun
著者名 Miyata, Haruka
著者名 Kikuchi, Hiroshi
著者名 Matsumoto, Ryuji
著者名 Osawa, Takahiro
e-Rad_Researcher 90250422 著者名 Shinohara, Nobuo
言語	英語
キーワード	Complication
	Radical cystectomy
	Bladder cancer
	Mortality
	Reoperation
発行日	2022-01
出版者	Elsevier
収録物名	Urologic oncology
巻(号)	40(1)
ページ	11.e17-11.e25
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
PISSN	1078-1439
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1016/j.urolonc.2021.09.005