Complications within 90 days after radical cystectomy for bladder cancer: results of a multicenter prospective study in Japan.

We prospectively evaluated the 90-day postoperative mortality and morbidity of open radical cystectomy by using a standardized reporting methodology. Additionally, we assessed the preoperative characteristics to determine risk factors for major complications.

This multicenter prospective study included 185 consecutive patients undergoing open radical cystectomy from October 2010 through March 2014. Postoperative complications within 90 days were recorded and graded according to the modified Clavien-Dindo classification.

Totally, 328 postoperative complications were observed in 149 patients (80.5%). Of these events, 73 (22.2%) were high grade (≥ Grade III), and developed in 46 patients (24.9%). Three patients (1.6%) died postoperatively. Urinary tract infection, wound complications, and paralytic ileus were common complications that occurred in 55 (29.7%), 42 (22.7%) and 41 (22.2%) patients, respectively. Ureteroenteric stricture was diagnosed in 13 of the 151 patients (8.6%) undergoing intestinal urinary diversion. Emergency room visits were required for 13 patients (7.0%) and readmission after discharge was needed for 36 (19.5%). A body mass index ≥ 25 kg/m2, smoking history and Charlson Comorbidity Index ≥ 2 were independent risk factors for high-grade complications, and their odds ratios (95% confidence intervals) were 2.357 (1.123-4.948), 2.843 (1.225-6.596) and 3.025 (1.390-6.596), respectively.

Open radical cystectomy is associated with a high incidence of postoperative complications. Most, however, are of low grade. Our results suggest that obesity, a smoking history, and increasing comorbidity are risk factors for major complications.

International journal of clinical oncology. 2018 Feb 13 [Epub ahead of print]

Megumi Hirobe, Toshiaki Tanaka, Tetsuya Shindo, Koji Ichihara, Hiroshi Hotta, Atsushi Takahashi, Ryuichi Kato, Masahiro Yanase, Masanori Matsukawa, Naoki Itoh, Yasuharu Kunishima, Keisuke Taguchi, Hiroki Horita, Naoya Masumori

Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan., Division of Urology, Asahikawa Red Cross Hospital, Asahikawa, Japan., Division of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan., Division of Urology, Muroran City General Hospital, Muroran, Japan., Division of Urology, Sunagawa City Medical Center, Sunagawa, Japan., Division of Urology, Takikawa Municipal Hospital, Takikawa, Japan., Division of Urology, NTT-East Corporation Sapporo Medical Center, Sapporo, Japan., Division of Urology, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Japan., Division of Urology, Oji General Hospital, Tomakomai, Japan., Division of Urology, Hokkaido Saiseikai Otaru Hospital, Otaru, Japan., Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan. .