To identify protective and risk factors of early postoperative complications after robot-assisted radical cystectomy for urothelial bladder carcinoma.
Data of all robot-assisted cystectomy performed in six french centers between February 2010 and December 2019 were retrospectively reviewed.
All robot-assisted radical cystectomy for bladder cancer (muscle-invasive and high-risk or BCG-resistant non muscle-invasive bladder cancer) were included. Perioperative outcomes and early postoperative complications (in the first 30 days) were collected. Multivariate analysis was performed to identify factors associated to early postoperative complications.
270 patients were included. The overall incidence of early postoperative complications after robot-assisted radical cystectomy was 52.2% (27% of major complications). Most frequent complications were infectious complications (24.4%) and paralytic ileus (15.6%). Anticoagulant therapy (OR=2.909, 95%CI 1.003 to 8.432) and uretero-enteric anastomosis type Wallace II (OR=4.4, 95%CI 1.435 to 13.489) were associated with a higher rate of overall complications. Complete intracorporeal derivation was a protective factor (OR=0.399, 95%CI 0.222 to 0.718). Tabacco consumption, anticoagulant therapy, uretero-enteric anastomosis type Wallace II were associated with a higher rate of minor complications (OR=2.01, 95%CI 1.079 to 3.744; OR=2.495, 95%CI 1.022 to 6.089; OR=3.836, 95%CI 1.384 to 10.63 respectively). Opioid-Free Anaesthesia was associated with a lower rate of infectious complications (OR=0.148, 95%CI 0.034 to 0.644).
Early postoperative complications rate after robot-assisted radical cystectomy for urothelial bladder carcinoma is high. Encouraging complete intracorporeal diversion and promoting Opioid-Free Anaesthesia seem to reduce postoperative complications in the first 30 days. Prospective studies are needed to provide a high level of evidence.
Journal of endourology. 2021 Dec 21 [Epub ahead of print]
Marie Mermier, Pierre Baron, Mathieu Roumiguie, Anne-Sophie Bajeot, Geraldine Pignot, François Lannes, Guillaume Ploussard, Anis Gasmi, Karim Bensalah, Ophélie Perrot, Morgan Rouprêt, Franck Bruyere, Benjamin Pradere, Gregory Verhoest
CHU Rennes, 36684, 2 rue Henri Le Guilloux, Rennes, France, 35000; ., CHU Tours, 26928, Tours, Centre, France; ., Centre Hospitalier Universitaire de Toulouse, 36760, urology, Toulouse, Midi-Pyrénées, France; ., CHU Toulouse, 36760, Toulouse, France; ., Institut Paoli-Calmettes, 56181, UROLOGY, Marseille, France; ., Institut Paoli-Calmettes, 56181, Marseille, France; ., Clinique Capio La Croix du Sud, 538719, Quint-Fonsegrives, Occitanie, France; ., CHU Rennes, 36684, Rennes, France; ., Rennes University Hospital (France), Urology, 2 rue Henri Le Guillou, Rennes, France, 35000; ., Pitié-Salpêtrière Academic Hospital, Paris, France; ., Pitié-Salpêtrière Academic Hospital, Department of Urology, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France; ., CHRU Tours, 26928, urology, 2 bd Tonnellé, Tours, France, 37044; ., CHU Tours, Department of urology, 2 boulevard tonnellé, Tours, France, 37000; ., RENNES Univeristy Hospital, Urology, Henri Le Guillou St, RENNES, France, 35033; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/34931545