PD9-08 RISK ASSESSMENT OF LATE COMPLICATIONS AFTER ROBOTIC RADICAL CYSTECTOMY WITH TOTAL INTRACORPOREAL URINARY DIVERSION

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You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion I1 Apr 2015PD9-08 RISK ASSESSMENT OF LATE COMPLICATIONS AFTER ROBOTIC RADICAL CYSTECTOMY WITH TOTAL INTRACORPOREAL URINARY DIVERSION Mariaconsiglia Ferriero, Giuseppe Simone, Rocco Papalia, Salvatore Guaglianone, and Michele Gallucci Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Rocco PapaliaRocco Papalia More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , and Michele GallucciMichele Gallucci More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.935AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic radical cystectomy (RRC) with intracorporeal urinary diversion (UD) is a challenging procedure with a high rate of perioperative complications. In this study we assessed the risk of late complications after RRC with intracorporeal UD. METHODS From October 2012 to October 2014, 100 consecutive unselected patients with cT2-4a/cN1-3/cM0 bladder cancer underwent RRC, extended lymphadenectomy and totally intracorporeal UD. Baseline demographics, perioperative and follow up data were prospectively collected. Univariable and multivariable regression analysis were performed to identify independent predictors of surgery related (SR) and any kind of late complications at six-mo evaluation. RESULTS Out of 100 RRC, we selected 87 consecutive patients with a minimum 6-mo follow up. Sixty-nine patients received a Padua Ileal bladder (54 male and 15 female), while 18 patients received an ileal conduit. At a six-mo follow up 60 (68.9%) patients experienced any kind of late complication, 49 (56.4%) were SR. Ortotopic UD, preoperative eGFR and learning curve were significant predictors of SR complication at univariable analysis (p= 0.032, p=0.042 and p=0.05, respectively). At multivariable analysis, the only independent predictor of surgical related late complications was orthotopic UD (p = 0.010; HR: 5.01 [95% CI, 1.47–17.04]). Learning curve and preoperative eGFR were significant predictors of any complications at univariable analysis (p= 0.008, and p=0.044, respectively). At multivariable analysis, the only independent predictor of any kind of late complications was the learning curve (p = 0.025; HR: 0.97 [95% CI, 0.95–0.99]). CONCLUSIONS RRC with intracorporeal neobladder is feasible but associated to higher risks of SR complications at six-mo evaluation. Learning curve plays a key role for a stepwise reduction of perioperative complications. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e197-e198 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariaconsiglia Ferriero More articles by this author Giuseppe Simone More articles by this author Rocco Papalia More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...