MP49-02 THE EFFECT OF SURGICAL COMPLEXITY ON PERIOPERATIVE OUTCOMES OF ROBOT-ASSISTED RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I (MP49)1 Apr 2020MP49-02 THE EFFECT OF SURGICAL COMPLEXITY ON PERIOPERATIVE OUTCOMES OF ROBOT-ASSISTED RADICAL CYSTECTOMY Ahmed Elsayed*, Naif Aldhaam, Zhe Jing, Jennifer Osei, Mohammad Durrani, Zachary Kurbiel, Michael Mostowy, Alat Siam, Tarik Babar, Ahmed Hussein, and Khurshid Guru Ahmed Elsayed*Ahmed Elsayed* More articles by this author , Naif AldhaamNaif Aldhaam More articles by this author , Zhe JingZhe Jing More articles by this author , Jennifer OseiJennifer Osei More articles by this author , Mohammad DurraniMohammad Durrani More articles by this author , Zachary KurbielZachary Kurbiel More articles by this author , Michael MostowyMichael Mostowy More articles by this author , Alat SiamAlat Siam More articles by this author , Tarik BabarTarik Babar More articles by this author , Ahmed HusseinAhmed Hussein More articles by this author , and Khurshid GuruKhurshid Guru More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000911.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous surgery and/or radiation can lead to significant intra-abdominal adhesions and therefore, can add to the complexity of surgery, and render minimally invasive surgery more challenging. We hereby report the perioperative outcomes of patients who underwent robot-assisted radical cystectomy (RARC) and have a history of previous pelvic surgery and/or radiation. METHODS: Retrospective review of our prospectively maintained database between 2005 and 2018. 589 RARCs were identified. Patients were divided into three groups based on surgical complexity; Complexity grade 1 (CG1) included patients who did not have any history of prior pelvic surgery or radiation (n=323); Complexity grade 2 (CG2) included those who had history of a single pelvic surgery or radiation (n=186); and Complexity grade 3 (CG3) included those who had history of 2 or more pelvic surgeries, or one or more pelvic surgery and radiation (n=80). All groups were compared in terms of perioperative characteristics and pathologic outcomes. Multivariate linear and logistic regression models were used to depict the predictors of operative time, ≥500 ml blood loss, 90-day complications, high grade complications, and readmissions. RESULTS: Mean age was 69 ± 11 years with a median follow up of 52 months. CG 3 were more likely to have an ASA ≥3 (CG3: 72% vs CG1: 49% and CG2: 59%, p<0.01), less likely to receive neobladder (CG3: 3% vs CG1: 13%, vs CG2: 6%, p<0.01), more 90-day complications compared (CG3: 74%, CG1: 59%, CG2: 68%, p=0.02), and more high grade complications (CG3: 24%, CG1: 13%, CG2 18%, p=0.03). On multivariate linear and logistic regression models, CG 3 was significantly associated with higher 90-day overall complications (OR 2.18, 95% CI 1.21-3.94, p<0.01) but not estimated blood loss, longer operative time, 90-day high grade complications and readmissions (Table 1). CONCLUSIONS: Higher surgical complexity was associated with higher overall complications, but not estimated blood loss, longer operative time, high grade complications and readmissions. Source of Funding: Roswell Park Alliance Foundation © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e739-e739 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Elsayed* More articles by this author Naif Aldhaam More articles by this author Zhe Jing More articles by this author Jennifer Osei More articles by this author Mohammad Durrani More articles by this author Zachary Kurbiel More articles by this author Michael Mostowy More articles by this author Alat Siam More articles by this author Tarik Babar More articles by this author Ahmed Hussein More articles by this author Khurshid Guru More articles by this author Expand All Advertisement PDF downloadLoading ...