Perioperative complications during radical cystectomy and double cutaneous ureterostomy using Clavien system

Abstract

Objective To explore the Clavien complications of patients given radical cystectomy and double cutaneous ureterostomy and to analyze the influencing factors. Methods The clinical data of 117 cases undergoing radical cystectomy and double cutaneous ureterostomy from January 2002 to June 2015 were reviewed. The Clavien classification system was carried out to stratify perioperative complications. Logistic regression analysis was applied to define possible predictors of the perioperative complications. Results Of the 117 subjects at least 1 perioperative complication developed in 51, including 3 cases of intraoperative complications. According to the Clavien system, 30 patients had grade 1-2, and 21 patients had grade 3-4 complications. The most frequent complication was incision-related complications, followeb by the gastrointestinal complications and lung infections. The total incidence of perioperative complications was lower in the laparoscope group than in the open surgery group (28.57% vs. 48.31%, χ2= 0.171, P=0.680), and the incidence of perioperative complications of Clavien 1-2 was lower in the laparoscope group than in the open surgery group with the difference being statistically significant (17.86% vs. 39.33%, χ2=4.363, P=0.037). Logistic regression analysis showed that hypoproteinemia, hospital stay and intranperative transfusion were the influencing factors of perioperative complications in patients undergoing radical cystectomy and double cutaneous ureterostomy (Respectively, χ2=10.131, P=0.003; χ2=8.685, P=0.012; χ2=6.675, P=0.018). Conclusion Radical cystectomy with double cutaneous ureterostomy is associated with a high perioperative comlications. Hypoproteinemia, longer hospital stay and intraoperative transfusion are independently associated with any complication in these patients. The Clavien system is a validated method that can be successfully used to stratify and evaluate perioperative complications during radical cystectomy and double cutaneous ureterostomy. Key words: Radical cystectomy; Double cutaneous ureterostomy; Perioperative complications; Clavien classification system; Urinary bladder neoplasms