In-Hospital Complications After Cystectomy Common

In-hospital complications are common among urinary bladder cancer (UBC) patients treated with radical cystectomy, according to a study published online in BJU International.

Mieke van Hemelrijck, PhD, of the King's College London School of Medicine, and colleagues examined 7,608 patients who underwent radical cystectomy in Sweden from 1964 to 2008. Diagnosis of UBC was determined from data found in the National Cancer Register, and patients were subdivided by diversion type.

Urinary tract infection (UTI)/septicemia was the most common complication with an incidence of 127.3 episodes per 1,000 person years overall. The highest incidence was among patients with an orthotopic neobladder (139.62 episodes per 1,000 person years).  UTI/septicemia was 11% and 21% more likely with continent cutaneous reservoir, and orthotopic neobladder, respectively, than with ileal conduit, according to the researchers.

Kidney failure and bowel obstruction were the second and third most common complication, respectively, with an incidence of 53.15 and 50.78 episodes per 1,000 person years. Kidney failure was 19% less likely with orthotopic neobladder thanwith ileal conduit. Bowel obstruction was 36% less likely with orthtopic neobladder that with ileal conduit.

In addition, patients faced different complication risks depending on their diversion type. Patients treated with an ileal conduit were associated with a greater risk of bowel obstruction, but a lower risk of other complications compared to other diversions such as orthopedic neobladder.

The authors noted that their study was unique in that it looked at a patient population across 40 years of data, allowing for comparisons between different complications to be made across diversion types and creating a broader understanding of radical cystectomy complications.

“The present data show that complications after radical cystectomy and urinary diversion are numerous and continue to accumulate for many years after surgery, suggesting that follow-up of these patients should be lifelong,” they concluded.

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