PREDICTORS OF EARLY SEVERE COMPLICATIONS AFTER RADICAL CYSTECTOMY

Background. Radical cystectomy (RC) with urinary diversion is one of the most traumatic operations in urologic oncology. This paper estimates the frequency and severity of complications due to successive series of RC and analyzes the predictors of serious events after surgery. Materials and methods. All cases of complications were selected from the medical records of 408 patients who had undergone RC with urinary diversion at the N.N. Alexandrov Research and Practice Center of Oncology and Medical Radiology in 1999 to 2008. The frequency of grades 3 to 5 complications was studied in relation to various variables, by applying the univariate logistic regression analysis. The multivariate analysis of the most important parameters was made. Odds ratios (OR), 95% confidence intervals (CI), and statistical significance (p) were calculated for all parameters. Results. A total of 132 complications were recorded in 91 (22%) patients. According to the severity of the disease, the complications were divided as follows: grades 1 [n=26 (20%)], 2 [n=39 (30%)], 3 [(n=48 (36%)], 4 [(n=5 (4%)], and 5 [(n=14 (10%)] complications. Body mass index > 25 (OR 2,62; 95% CI 1,23-5,55; p=0,012) and a surgeons experience (> 100 cystectomies) (OR 0,48; 95% CI 0,240-0,99; p=0,04) were of prognostic value in the multivariate analysis. Conclusion. A considerable number of complications were noted after RC with urinary diversion. The multivariate analysis has shown that overweight increases the risk of severe complications after surgery and a surgeons rich experience reduces it.

radical cystectomy, severe complications, risk factors, classification of the severity of complications