MP60-10 PREDICTORS OF EARLY POST-OPERATIVE READMISSION AFTER OPEN AND ROBOTIC RADICAL CYSTECTOMY FOR PATIENTS WITH BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2014MP60-10 PREDICTORS OF EARLY POST-OPERATIVE READMISSION AFTER OPEN AND ROBOTIC RADICAL CYSTECTOMY FOR PATIENTS WITH BLADDER CANCER Jordan Allen, Ahmed Sarhan, and Ahmad Shabsigh Jordan AllenJordan Allen More articles by this author , Ahmed SarhanAhmed Sarhan More articles by this author , and Ahmad ShabsighAhmad Shabsigh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1764AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Robotic radical cystectomy (RRC) is a minimally-invasive technique with reported lower low grade complications rate compared to the Open radical cystectomy (ORC). Regardless of surgical technique; cystectomy remains a complex procedure with many potential complications and high readmission rate. We analyze the incidence, cause and predictors of readmission after ORC and RRC. Methods We retrospectively reviewed a total of 337 patients who underwent radical cystectomy at our institution from April 2008 through April 2013. Pre-operative patient characteristics and perioperative outcomes were analyzed. All perioperative complications within 30 days of surgery were analyzed and graded according to the Clavien complication grading system and correlated to post-operative readmission. Univariate and multivariate regression models were used to identify the predictors of post-operative readmission. Results A total of 115 and 225 patients underwent robotic and open radical cystectomy with urinary diversion for bladder cancer, respectively. The groups had similar pre-operative characteristics including age, BMI, Charlson-Romano scores, prior abdominal surgery or pelvic radiation, renal function, presence of hydronephrosis, and ASA scores. Significantly more patients undergoing an ORC had a continent urinary diversion. Overall, 26 (23.2%) RRC patients and 57 (25.3%) ORC patients had at least one readmission within 30 days of surgery (p = 0.7). Infections and gastrointestinal complications were the most common causes 27% and 25% respectively. On multivariate regression analysis weight, was the only significant predictor of readmission (p<0.05). Both history of active smoking and chemotherapy were strong predictors (p=0.09) but not significant. Factors such as prior history of dyspnea, pelvic radiation therapy, ability to walk, diabetes, renal function, surgical technique, and urinary diversions were not significant predictors of post-operative readmission. Conclusions Whether performed open or robotically, radical cystectomy is a complex procedure with a high readmission rate. The minimally-invasive approach did reduce the number of readmission, predicting readmission is a difficult task, and obesity is a major risk factor. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e636 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jordan Allen More articles by this author Ahmed Sarhan More articles by this author Ahmad Shabsigh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...