Thirty-day complications of radical cystectomy and factors that influence their development

Objective: to identify the most important factors influencing the development of complications after radical cystectomy (RCE).

Materials and methods. The results of 182 RCEs performed in September 2014 and December 2016 were analyzed. The patients included 152 (83.5 %) men and 30 (16.5 %) women. The patients’ age ranged from 31 to 84 years (mean age 62.3 years). An orthotopic urinary reservoir was formed in 138 (75.8 %) patients. Postoperative complications were evaluated according to the Clavien–Dindo classification. The calculations were made with a computer program for SPSS Statistics 16.

Results. No complications were recorded in 84 (46.2 %) patients within 30 days after RCE. The development of various postoperative adverse reactions was observed in 98 (53.8 %) patients. The most common complications were gastrointestinal (26.9 %) and infectious (25.8 %). Sixteen (8.8 %) patients developed grade I complications; grades II, III, IV, and V complications were seen in 53 (29.1 %), 21 (11.5 %), 5 (2.7 %), in 3 patients, respectively. Thirty-day mortality was 1.64 %. Univariate regression analysis has established that overweight (p = 0.031), T status (p = 0.021), preoperative hemoglobin levels (p = 0.001), intraoperative blood loss (p = 0.009), and intraoperative abdominal cavity infection (p <0.001) play a significant role in the development of complications following RCE. Multivariate regression analysis has revealed that the frequency of complications after RCE is influenced by body mass index (p = 0.008), preoperative anemia (p = 0.034), blood loss (p = 0.003), and intraoperative abdominal cavity infection (p <0.001).

Conclusion. RCE is often accompanied by the development of different categories and severity of complications. Identification of risk factors for their complications will be able to elaborate effective ways for their prevention.