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Khirurgii

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Year 2018 Vol. 26 No 4

UROLOGY

À.À. RYNDZIN, L.À. ZAITSEVA, I.F. SHISHLO, A.V. POLUJANCHIK, S.A. KRASNY

PREDICTION OF SEVERE POSTOPERATIVE COMPLICATIONS OF RADICAL CYSTECTOMY

N.N. Alexandrov National Cancer Center of Belarus, Minsk,
The Republic of Belarus

Objective. To access the predictors and structure of the postoperative Clavien-Dindo grade ≥3 complications in the bladder cancer patients after the radical cystectomy (RC) and to create the model to predict the likelihood of such complications.
Methods. Results of the radical cystectomy series performed in N.N. Alexandrov National Cancer Center of Belarus during the period from 1999 to 2012 (849 patients) were retrospectively analyzed. The information about postoperative Clavien-Dindo grade ≥3 complications during 30 days after the radical cystectomy was obtained from medical records. By means of uni- and multivariate logistic regression analyses, the relationship of severe postoperative complications with perioperative parameters was assessed.
Results. Postoperative complications were registered in 351 patients from 849 (41%). 116 patients had 128 Clavien-Dindo grade ≥3 complications (13.7%, 95% CI 11.4-16.0). Multivariate regression analysis revealed the statistically significant correlation of complications frequency of Clavien-Dindo grade ≥3 with the following factors: surgeon’s experience (<50 versus >200 RC: OR 3.252; 95% CI 1.297-8.157; p=0.011; 50-200 versus >200 RC: OR 2.61; 95% CI 1,456-4,89; p=0.002), patient’s age (<70 versus ≥70: OR 1.779; 95% CI 0.125-2.815; p=0.014), body mass index (BMI) (<25 versus ≥25: OR 1.779; 95% CI 1.117-2.821; ð=0.04), previous open bladder surgery (OR 3.479; 95% CI 1.055-11.409; ð=0.015), preoperative serum creatinine level (<155 mmol/l versus ≥155 mmol/l, OR 2.762, 95% CI 1.415-5.388; p=0.003).
Conclusions. Complication rate is influenced by patient’s parameters (BMI ≥25, age ≥70 and serum creatinine level ≥155 mmol/l) and surgeon experience, which should be taken into account before planning radical cystectomies.

Keywords: urinary bladder neoplasms, radical cystectomy, severe complications, complication grade classification, prognosis
p. 447-456 of the original issue
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Address for correspondence:
223040, The Republic of Belarus,
Minsk region, Lesnoy-1,
N.N. Alexandrov National Cancer
Center of Belarus,
Oncourological Unit,
Tel. mobile: +375 29 667-09-10,
e-mail: aryndzin@gmail.com,
Aliaksei A. Ryndzin
Information about the authors:
Ryndzin Aliaksei A., Urologist, the Oncourological Unit, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of Belarus
http://orcid.org/0000-0001-5642-8397
Zaitseva Lidya A., Junior Researcher of the Carcinogenesis Laboratory of the Diagnostic Department, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of Belarus.
http://orcid.org/0000-0001-8004-1942
Shishlo Iosif F., PhD, Oncologist-Surgeon, the Hepatopancreatobiliary Pathology Unit, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of Belarus.
http://orcid.org/0000-0002-3114-3974
Poluyanchik Andrei V., PhD, Head of the Operative Unit, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of Belarus.
http://orcid.org/0000-0003-0718-1548
Krasny Sergey A., MD, Professor, Corresponding Member of NAS of RB, Deputy Director for Research, N.N. Alexandrov National Cancer Center of Belarus, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-3244-5664
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