Lessons Learned From 1,000 Neobladders: The 90-Day Complication Rate

No AccessJournal of UrologyAdult Urology1 Sep 2010Lessons Learned From 1,000 Neobladders: The 90-Day Complication Rate Richard E. Hautmann, Robert C. de Petriconi, and Bjoern G. Volkmer Richard E. HautmannRichard E. Hautmann Department of Urology, University of Ulm, Ulm, Germany More articles by this author , Robert C. de PetriconiRobert C. de Petriconi Department of Urology, University of Ulm, Ulm, Germany More articles by this author , and Bjoern G. VolkmerBjoern G. Volkmer Department of Urology, University of Ulm, Ulm, Germany Klinikum Kassel, Kassel, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.05.037AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report the 90-day morbidity of the ileal neobladder in a large, contemporary, homogenous series of patients who underwent radical cystectomy at a tertiary academic referral center using a standard approach. Materials and Methods: Between January 1986 and September 2008 we performed 1,540 radical cystectomies. A total of 281 patients had an absolute contraindication for orthotopic reconstruction. The remaining 1,259 patients were candidates for a neobladder. Of these patients 1,013 (66%) finally received a neobladder and form the basis of this report. All patients had a thorough followup until December 2008 or until death. All complications within 90 days of surgery were defined, categorized and classified by an established 5 grade and 11 domain modification of the original Clavien system. Results: Of 1,013 patients 587 (58%) experienced at least 1 complication within 90 days of surgery. Infectious complications were most common (24%) followed by genitourinary (17%), gastrointestinal (15%) and wound related complications (9%). The 90-day mortality rate was 2.3%. Of the patients 36% had minor (grade 1 to 2) and 22% had major (grade 3 to 5) complications. On univariate analysis the incidence and severity of the 90-day complications rate correlate highly significantly with age, tumor stage, American Society of Anesthesiologists score and preoperative comorbidity. Conclusions: Radical cystectomy and ileal neobladder formation represent a major surgery with potential relevant early complications even in the most experienced hands. The rate of severe and lethal complications is acceptably low. 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Volume 184Issue 3September 2010Page: 990-994 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordspostoperative complicationscystectomyurinary bladder neoplasmsurinary diversionMetrics Author Information Richard E. Hautmann Department of Urology, University of Ulm, Ulm, Germany More articles by this author Robert C. de Petriconi Department of Urology, University of Ulm, Ulm, Germany More articles by this author Bjoern G. Volkmer Department of Urology, University of Ulm, Ulm, Germany Klinikum Kassel, Kassel, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...