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Understanding simple cystectomy for benign disease: A unique patient cohort with significant risks

Urology Aug 31, 2017

Aisen CM, et al. – The physicians conducted this work to explore patient characteristics and complications of simple cystectomy for benign disease. A secondary aim was to compare these parameters to those in radical cystectomy. The outcomes demonstrate that the benign and radical cystectomy patients are different patient populations, with benign patients being younger with higher ASA class. Even in benign disease, cystectomy is not without risk and patients should be counseled accordingly.

Methods
  • Researchers applied current procedural terminology codes to distinguish patients within the National Surgical Quality Improvement Program who underwent cystectomy (2005–2014).
  • They applied International Classification of Disease (ICD9) codes to classify patients with benign or malignant diagnoses.
  • They distinguished perioperative complications (30–day) and applied logistic regression analysis to distinguish factors associated with morbidity.

Results
  • They distinguished 389 patients who had a cystectomy for benign diagnosis.
  • As per the data, 235 (60.4%) had complications.
  • It was showed that the most frequently reported complication was bleeding (requiring a transfusion within 72 h) in 150 (38.6%) patients.
  • They demonstrated that other complications were wound infection (63; 16.2%), respiratory complication (29; 7.5%), wound dehiscence (8; 2.1%) renal complication (9; 2.3%), cardiovascular complication (6; 1.5%), and post op DVT (8; 2.1).
  • Moreover, on multivariate analysis diabetes (OR 1.9, p=0.04) and smoking (OR 1.8, p=0.03) were correlated with increased odds of any complication.
  • In addition, compared to those with cystectomy for malignancy this cohort was younger, with higher ASA scores and CKD stages and the complication risk was similar (60.4% vs. 57.7%, p=0.3).
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