A Critical Analysis of Perioperative Mortality From Radical Cystectomy
- 1 March 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 175 (3), 886-890
- https://doi.org/10.1016/s0022-5347(05)00421-0
Abstract
Operative mortality from radical cystectomy has decreased as a result of improvements in surgical and anesthetic care. We reviewed the perioperative deaths from a large group of patients treated with radical cystectomy for primary bladder cancer. All perioperative mortalities from radical cystectomy were identified from a single high volume institution. The medical records were reviewed to assess the cause of death as well as possible contributing factors. From August 1971 to December 2001, 1,359 patients with primary bladder cancer were treated with radical cystectomy and pelvic iliac lymphadenectomy at our institution. Of these patients, 27 (2%) died within 30 days of surgery or before discharge from hospital. Median patient age at surgery was 67 years (range 47 to 78) and males accounted for 81% of the patients. The median time to death was 28 days from cystectomy (range 0 to 80). Most deaths were cardiovascular related (including acute myocardial infarction, cerebrovascular accident, arterial thrombosis) or due to septic complications with resulting multi-organ system failure, followed by pulmonary embolism, hepatic failure and hemorrhage. Septic related mortality was most often associated with postoperative urine or bowel leak. While most deaths occurred before hospital discharge, 2 patients died at home due to a late pulmonary embolus. No association was seen between pathological stage or type of urinary diversion and mortality. Perioperative mortality from radical cystectomy is low in this group of patients. Most deaths are due to cardiovascular or septic complications. Careful patient selection and meticulous surgical technique may help decrease the incidence of perioperative mortality.This publication has 15 references indexed in Scilit:
- Low molecular weight heparin for the prevention of venous thromboembolism after abdominal surgeryBritish Journal of Surgery, 2004
- Analysis of Early Complications After Radical Cystectomy: Results of a Collaborative Care PathwayJournal of Urology, 2002
- CAUSES OF INCREASED HOSPITAL STAY AFTER RADICAL CYSTECTOMY IN A CLINICAL PATHWAY SETTINGJournal of Urology, 2002
- The changing pattern of mortality and morbidity from radical cystectomyBJU International, 2000
- Radical cystectomy for elderly patients with bladder carcinomaCancer, 1998
- Radical Cystectomy for Carcinoma of the Bladder: Critical Evaluation of the Results in 1,026 CasesJournal of Urology, 1997
- Complications of Radical Cystectomy and Urinary Diversion: A Retrospective Review of 675 Cases in 2 DecadesJournal of Urology, 1992
- Results of Contemporary Radical Cystectomy for Invasive Bladder Cancer: A Clinicopathological Study With an Emphasis on the Inadequacy of the Tumor, Nodes and Metastases ClassificationJournal of Urology, 1991
- Complications of Radical Cystectomy for Carcinoma of the BladderJournal of Urology, 1980
- Cystectomy and Urinary DiversionJournal of Urology, 1966